THE SUBCOSTAL NERVE (OUCH) - ANATOMICAL AWARENESS IN SALTER INNOMINATE OSTEOTOMY

The identification of the lateral cutaneous branch of the subcostal ne rve supplying the anterior gluteal region while using the modified Smi th-Petersen approach in performing Salter's innominate osteotomy has n ot been described previously. Following cadaveric dissection in six sp ecimens and after performing routine Salter's innominate osteotomy usi ng the modified Smith-Petersen approach in five patients, we found con sistently that the lateral cutaneous branch of the subcostal nerve cro ssed the iliac crest between 2 and 5 cm posterior to the anterior supe rior iliac spine. This important accidental finding has led us to take care in identifying and protecting this nerve from any undue injury t hat could cause blunting of sensation in the anterior gluteal region.