An anatomical research of the anterior pelvic surgical approach and its clinical application in the treatment of pelvic and acetabular fractures

Objectives: To provide the anatomical basis via the anterior pelvis surgical approach to treat pelvic and acetabulum fracture. Methods: (1) Ten formalized cadavers were dissected, observed within the hypogastric region and pelvic anatomical position and variation. (2) On the basis of anatomical study, 20 patients with unstable pelvic fractures and 15 patients with acetabulum fracture were performed with the anterior pelvis surgical approach. Results: The separation could not separate and exposure of the spermatic cord/round ligament of the uterus; Separation of the rectus incision is located in the midline partial lateral 3 cm, is located in the inner side of arteriovenous cycle line position. Thus reducing the fire risk. And it helps to exposure corona mortis and vas deferens, etc. Dissection along the iliopectineal line, surgeon can exposure the operative field from the pubic symphysis to the sacroiliac joint and quadrilateral surface ahead. Clinical application of 35 patients, anatomic or satisfactory reduction was achieved. Conclusion: The anterior pelvis surgical approach provides excellent visualization to the anterior column, quadrilateral surface and permits good postoperative results for treatment of pelvic and acetabular fractures. It is an alternative and new surgical approach to access to the internal pelvis and medial wall of the acetabulum.