髋臼骨折髂腹股沟下入路的风险

The Risks of Subilioinguinal Approach in Acetabulum Fracture

目的探讨髂腹股沟下入路的风险及注意事项。方法对20具(40侧)成年国人尸体髂腹股沟区进行分层解剖,按临床髂腹股沟下入路步骤分析其存在的风险或注意事项。结果浅表血管神经存在较多变异易受损伤;髂股血管和深部淋巴系统易受到牵拉损伤;内侧窗显露时可因破坏耻骨肌孔下区结构导致股疝发生等,需注意预防或重建。结论髂腹股沟下入路相对经典的髂腹股沟入路虽对外侧窗显露充分,但并未减少中间窗和内侧窗显露时存在的问题,需进行改良。

Objective To explore the risks of subilioinguinal approach in the treatment of aeetabulum fractures by anatomical study. Methods Twenty adult cadaver were dissected according to the technique of subilioinguinal approach described by Farid in 2008. The risks and the announcements in this approach were analyzed combining clinical application together the correlated anatomic structure. Results There were some risks should be prevented due to the special anatomic features inelude the variation of superficial blood vessel and nerves, less mobility of iliofemoral vessels and lymphatic system. Femoral hernias was likely to occur because of the destroyed structure of myopectineal orifice inferior-area. Conclusion It is not yet decrease the risks to expose the middle and medial windows in subinguinal approach contrast to the classic approach, although the large exposure in lateral window.