AAS ›› 2014, Vol. 45 ›› Issue (6): 819-823.doi: 10.3969/j.issn.0529-1356.2014.06.015

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Anatomy and modification of the middle window in the subilioinguinal approach

XU Shun-li1 ZHAO Xue-song2 LÜ Xiang3 WANG Yi-sheng 1*   

  1. 1. Department of Orthopaedics, the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000, China; 2. Department of Orthopaedics, Angang General Hospital,He’nan Anyang 455000, China; 3. Department of Orthopaedics, Huojia RedCross Hospital, He’nan Xinxiang 453800, China
  • Received:2014-04-01 Revised:2014-06-03 Online:2012-12-06 Published:2014-12-06
  • Contact: WANG Yi-sheng E-mail:wys1954@163.com

Abstract:

Objective To provide the anatomical evidence to prevent vascular damage and lyphatical leakage during the subilioinguinal approach for acetabulum fracture. Methods Twenty human adult cadavers were dissected in the Anatomy Department of Xinxiang Medical University.The structures associated with the middle window of the subilioinguinal approach were observed. Results Inferior epigastric artery was derived from external iliac artery (57.5%) or femoral artery(17.5%), was (41.35±2.33)mm from pubic symphysis,and had a (40.23±5.23)° angle with external iliac artery.There was no difference between left and right sides,and no correlation with the width and length of pelvis. There was no fascia-like structure around the iliac blood vesses. The fascia-like structure was observed around the femoral blood vessels but it was easy to be separated from the surrounding structures. The angle between the origin of iliopectineal arch and the medial end of the inguinal ligament was sharp and at (15.20±6.79)°and filled by a thin membrane-like structure. The medial and inferior part of the iliac fascia was thick and had no correlation with the width and length of pelvis. Conclusion Blood vessel and lymphatic vessel are prone to injury in the subinguinal and inguinal approaches. Inferior part of iliac fascia and iliopectineal arch are compact, and thus the lateral window may pass through medially under the fascia iliaca.

Key words: Sub-ilioinguinal approach, Iliac fascia, Applied anatomy, Human