PELVIC OSTEOTOMIES - ANATOMIC PITFALLS AT THE ISCHIUM - A CADAVER STUDY

Pelvic osteotomies for acetabular dysplasia include an osteotomy of th e ischium. The potential anatomical hazards of three different osteoto mies of the ischium were assessed by performing a triple osteotomy in a series of 8 fresh cadaver pelvises. An oblique osteotomy above the s acrospinous ligament using a posterior approach requires that the infe rior gluteal and pudendal neurovascular bundles be mobilised and retra cted. A transverse osteotomy below the sacrospinous ligament using a p osterior approach can be performed in a relatively safe area between t he pudendal and sciatic nerves. A transverse osteotomy from anterior c an be performed through a modified Smith Peterson approach. The pudend al nerve medially, the sciatic nerve laterally and the medial circumfl ex artery distally are not visualised and are prone to damage.