Gänsslen Axel, Staresinic Mario, Krappinger Dietmar, Lindahl Jan
Department of Trauma Surgery, Hannover Medical School, Hannover, Germany.
Department of Trauma and Orthopedics, Johannes Wesling Hospital, Minden, Germany.
Arch Orthop Trauma Surg. 2024 Dec 18;145(1):65. doi: 10.1007/s00402-024-05667-x.
The today well accepted intrapelvic approach for acetabular and pelvic ring injury fixation was first described by Hirvensalo and Lindahl in 1993 followed by a more detailed description by Cole and Bolhofner in 1994. Compared to the well-known ilioinguinal approach, described by Letournel, this approach allows an intrapelvic view to the medial acetabulum, while using the ilioinguinal approach a more superior, extrapelvic view, is dissected to the area of the acetabulum. Several names have been used to describe the new intrapelvic approach with increasing usage, mainly ilio-anterior approach, extended Pfannenstiel approach, Stoppa-approach, Rives-Stoppa approach, modified Stoppa approach and recently anterior intrapelvic approach. Especially names including "Stoppa", based on the French surgeon Rene Stoppa, an inguinal hernia surgeon, have been discussed. In contrast to the presently used intrapelvic approach, the original the Rives-Stoppa approach refers to a sublay-retromuscular technique, which places a mesh posterior to the rectus muscle and anterior to the posterior rectus sheath without dissecting along the upper pubic ramus. Thus, intrapelvic approach is not a Rives-Stoppa approach. The Cheatle-Henry approach, another inguinal hernia approach, refers best to the presently used intrapelvic approach. Discussing the anatomy and the different dissections, this approach allows anteromedial access to the anterior column and a direct view from inside the true pelvis to the quadrilateral plate and medial side of the posterior column. Thus, we favor to use the term "Intrapelvic Approach".
目前广泛认可的用于髋臼和骨盆环损伤固定的盆腔内入路，最早由希尔韦萨洛和林达尔于1993年描述，随后科尔和博尔霍夫纳在1994年进行了更详细的描述。与勒图尔内描述的著名髂腹股沟入路相比，这种入路可以从盆腔内观察髋臼内侧，而使用髂腹股沟入路时，则是从盆腔外更靠上的位置观察髋臼区域。随着这种新的盆腔内入路使用越来越多，人们用了几个名称来描述它，主要有髂前入路、改良Pfannenstiel入路、斯托帕入路、里夫斯-斯托帕入路、改良斯托帕入路，以及最近的前方盆腔内入路。尤其值得一提的是，一些包含“斯托帕”的名称引发了讨论，这是基于法国外科医生勒内·斯托帕，他是一位腹股沟疝外科医生。与目前使用的盆腔内入路不同，最初的里夫斯-斯托帕入路是一种衬层-肌后技术，该技术将补片放置在直肌后方和腹直肌后鞘前方，而不沿耻骨上支进行解剖。因此，盆腔内入路并非里夫斯-斯托帕入路。另一种腹股沟疝入路——切特尔-亨利入路，最能代表目前使用的盆腔内入路。通过讨论其解剖结构和不同的解剖方式，这种入路能够从前内侧进入前柱，并从真盆腔内部直接观察四边形板和后柱内侧。因此，我们倾向使用“盆腔内入路”这一术语。
