The Iliopectineal Fascia: A Cadaveric Anatomical Study.
Journal
Journal of orthopaedic trauma
ISSN: 1531-2291
Titre abrégé: J Orthop Trauma
Pays: United States
ID NLM: 8807705
Informations de publication
Date de publication:
01 06 2021
01 06 2021
Historique:
accepted:
15
10
2020
pubmed:
24
10
2020
medline:
22
6
2021
entrez:
23
10
2020
Statut:
ppublish
Résumé
The iliopectineal fascia (IPF) serves as an important anatomical compass during the ilioinguinal and anterior intrapelvic approaches. The purpose of this investigation is to qualitatively and quantitatively describe the IPF by cadaveric dissection. Dissections were performed on 7 paired fresh-frozen cadaveric pelvic specimens. Measurements were made with surgical rulers to determine attachments of the IPF relative to surrounding anatomy. The IPF is the thickened anterior portion of the iliopsoas fascia, attached superolaterally at the iliac crest for a mean insertion distance of 2.5 cm (range, 2.0-3.0 cm), immediately posterior to the origin of the inguinal ligament. Inferomedially, the IPF attaches to a bony ridge along the apex of the iliopectineal eminence, between the pelvic brim posteriorly and the anterior wall of the acetabulum anteriorly (mean distance, 4.3 cm; range, 3.1-5.6 cm). The attachment at the iliopectineal eminence is 7.8 cm (range, 6.0-10.0 cm) from the pubic symphysis, measured curvilinearly along the brim. The mean length of the IPF between its superolateral and inferomedial attachments is 9.2 cm (range, 8.0-11.8 cm). Anterolaterally, the IPF is the site of attachment of the internal oblique and transversus abdominis. Posteriorly, the IPF continues as the iliopsoas fascia. The authors have sought clarity and reconciliation of the myriad terms and descriptions of the IPF and its surrounding anatomy. We recommend a thorough understanding of this anatomy to enable safe and effective surgery via the ilioinguinal and anterior intrapelvic approaches to the acetabulum.
Identifiants
pubmed: 33093295
pii: 00005131-202106000-00009
doi: 10.1097/BOT.0000000000001995
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
333-338Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors report no conflict of interest.
Références
Letournel E, Judet R. Fractures of the Acetabulum. 2nd ed. Berlin Heidelberg, Germany: Springer-Verlag; 1993:376.
Mayo KA. Surgical approaches to the acetabulum. Tech Orthop. 1990;4:24–35.
Cole JD, Bolhofner BR. Acetabular fracture fixation via a modified stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results. Clin Orthop Relat Res. 1994;305:112–123.
Mayo K, Unno F. The ilioinguinal surgical approach using a modified medial window: origin, evolution, and applications. A 34-year perspective. J Orthop Trauma. 2019;33(suppl 2):S14–S20.
Karunakar MA, Le TT, Bosse MJ. The modified ilioinguinal approach. J Orthop Trauma. 2004;18:379–383.
Tile M, Helfet DL, Kellam JF, et al. Fractures of the Pelvis and Acetabulum: Principles and Methods of Management. 4th ed. Geneva, Switzerland: AO Foundation, Thieme; 2015:600.
Sagi HC, Afsari A, Dziadosz D. The anterior intra-pelvic (modified rives-stoppa) approach for fixation of acetabular fractures. J Orthop Trauma. 2010;24:263–270.
Acland RD. The inguinal ligament and its lateral attachments: correcting an anatomical error. Clin Anat. 2008;21:55–61.
Standring S. Gray's Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. Berlin Heidelberg, Germany: Elsevier Limited; 2016:1078.
Gray H. Anatomy, Descriptive and Surgical. London, United Kingdom: John W Parker and Son, West Strand; 1858.
Pick TP. Anatomy, Descriptive and Surgical. A New Edition, Thoroughly Revised by American Authorities, from the 13th English Edition. Philadelphia and New York: Lea Brothers & Co; 1897.
Pick TP, ed. Anatomy, Descriptive and Surgical. 14th ed. London and Bombay: Longmans, Green, and Co; 1897.
Pick TP, Howden R. Anatomy, Descriptive and Surgical. A Revised American, from the 15th English, Edition. Philadelphia and New York, PA, NY: Lea Brothers & Co; 1901:416.
Lewis WH. Anatomy of the Human Body. 20th ed. Philadelphia, PA: Lea & Febiger; 1918.
Goss CM, ed. Gray's Anatomy. 27th ed. Philadelphia, PA: Lea & Febiger; 1959.
Warwick R, Williams PL. Gray's Anatomy. 35th British ed. Philadelphia, PA: W. B. Saunders Company; 1973.
Williams PL, Warwick R. Gray's Anatomy. 36th ed. Philadelphia, PA: W. B. Saunders Company; 1980.
Standring S. Gray's Anatomy: The Anatomical Basis of Clinical Practice. 40th ed. Berlin Heidelberg, Germany: Elsevier Limited; 2008.
Teague DC. Inguinal anatomy and retropubicvascular hazards of the ilioinguinal approach. Oper Tech Orthop. 1997;7:175–183.
Letournel E, Judet R. Fractures of the Acetabulum. Berlin Heidelberg, Germany: Springer-Verlag; 1981:236.