VASCULAR INJURY DURING TOTAL HIP-ARTHROPLASTY - THE ANATOMY OF THE ACETABULUM

We encountered a massive retroperitoneal haemorrhage due to perforatio n of the external iliac vein by a drill tip passing through the antero -superior quadrant of the acetabulum during cementless total hip arthr oplasty. An anatomical study of the acetabulum was undertaken to deter mine the safe zones for transacetabular screw fixation. Five cadavera were studied to find the proper locations for screws using acetabular quadrants. The postero-superior and postero-inferior acetabular quadra nts have good bone stock and are safe for the transacetabular replacem ent of screws. The antero-superior and inferior quadrants should be av oided. Screws placed in these quadrants may damage the external iliac artery and vein or the obturator vessels.