Trulson Alexander, Küper Markus Alexander, Trulson Inga Maria, Minarski Christian, Grünwald Leonard, Hirt Bernhard, Stöckle Ulrich, Stuby Fabian
Klinik für Unfall- und Wiederherstellungschirurgie der Eberhard-Karls-Universität Tübingen, BG Unfallklinik, Tübingen.
Institut für Klinische Anatomie und Zellanalytik, Eberhard-Karls-Universität Tübingen, Tübingen.
Z Orthop Unfall. 2019 Feb;157(1):22-28. doi: 10.1055/a-0621-9570. Epub 2018 Jun 14.
Dislocated pelvic fractures which require surgical repair are usually operated on via open surgery. Approach-related morbidity is reported with a frequency of up to 30%. The aim of this anatomical study was to prove the feasibility of endoscopic visualisation of the relevant anatomical structures in pelvic surgery and to perform completely endoscopic plate osteosynthesis of the acetabulum with available standard laparoscopic instruments.
In four human cadavers, we established an endoscopic preparation of the complete pelvic ring, from the symphysis to the iliosacral joint, including the quadrilateral plate and the sciatic nerve, and performed endoscopic plate osteosynthesis along the iliopectineal line.
The endoscopic preparation of the complete pelvic ring and the quadrilateral plate was demonstrated step-by-step, followed by completely endoscopic plate osteosynthesis along the pelvic brim. Endoscopic, radiographic, and schematic pictures are used to illustrate the technique.
The completely endoscopic preparation of the pelvic brim and the quadrilateral plate is feasible with available standard laparoscopic instruments. Moreover, plate osteosynthesis could be performed endoscopically. Further research on reduction techniques is necessary when planning to implement this technique into a clinical scenario.
需要手术修复的骨盆脱位骨折通常通过开放手术进行治疗。据报道，与手术入路相关的发病率高达30%。这项解剖学研究的目的是证明在骨盆手术中对相关解剖结构进行内镜可视化的可行性，并使用现有的标准腹腔镜器械对髋臼进行完全内镜下钢板接骨术。
在四具人体尸体上，我们建立了从耻骨联合到髂骶关节的完整骨盆环的内镜准备，包括四边形板和坐骨神经，并沿髂耻线进行内镜下钢板接骨术。
逐步展示了完整骨盆环和四边形板的内镜准备，随后沿骨盆边缘进行了完全内镜下钢板接骨术。使用内镜、影像学和示意图来说明该技术。
使用现有的标准腹腔镜器械对骨盆边缘和四边形板进行完全内镜准备是可行的。此外，可以在内镜下进行钢板接骨术。在计划将该技术应用于临床时，有必要对复位技术进行进一步研究。
