RETROPUBIC VASCULAR HAZARDS OF THE ILIOINGUINAL EXPOSURE - A CADAVERIC AND CLINICAL-STUDY

In the course of ilioinguinal exposure, significant bleeding can occur from anastomotic vascular channels along the posterior aspect of the superior pubic ramus. A cadaveric study was undertaken to quantify and qualify these communicating vascular systems. We made bilateral ilioi nguinal exposures on 40 cadavers. All vessels >2 mm in diameter, conne cting the obturator system with a more superficial system, were single d out and their courses recorded. Fifty-eight of 79 sides (73%) had at least one large-diameter communicating vascular channel along the pos terior aspect of the superior pubic ramus. In 47 of the 79 exposures ( 59%) communicating veins were noted. Arterial channels were identified in 34 exposures (43%). A prospective clinical study was also performe d. Thirty-eight consecutive patients with displaced acetabular fractur es were treated surgically using ilioinguinal exposures. Fourteen of t he patients (37%) had anastomotic vessels. This study confirms the var iability of the retropubic vascular system.