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International Orthopaedics

, Volume 18, Issue 1, pp 29–31 | Cite as

Vascular injury during total hip arthroplasty: the anatomy of the acetabulum

  • S. K. Hwang
Article

Summary

We encountered a massive retroperitoneal haemorrhage due to perforation of the external iliac vein by a drill tip passing through the antero-superior quadrant of the acetabulum during cementless total hip arthroplasty. An anatomical study of the acetabulum was undertaken to determine 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-in-ferior acetabular quadrants have good bone stock and are safe for the transacetabular replacement of screws. The antero-superior and inferior quadrants should be avoided. Screws placed in these quadrants may damage the external iliac artery and vein or the obturator vessels.

Keywords

Iliac Artery Screw Fixation Iliac Vein Bone Stock Safe Zone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Nous rapportons un cas d'hémorragie sous-péritonéale massive par plaie de la veine iliaque externe due à une mèche préparant la mise en place d'une vis au niveau du quadrant antérosupérieur du cotyle au cours d'une arthroplastie totale non cimentée de la hanche. Une étude anatomique a été entreprise afin de déterminer les zones sûres du cotyle pour la fixation par vis des prothèses totales sans ciment. Cinq cadavres ont été examinés pour trouver la localisation la plus favorable selon les quadrants cotyloïdiens. Les quadrants postéro-supérieur et postéro-inférieur possèdent une importante épaisseur osseuse et sont sans danger pour la pose de vis trans-acétabulaires. Les quadrants antéro-supérieur et inférieur doivent être évités parce que les vis imparfaitement placées à ce niveau peuvent léser l'artère et la veine iliaque externe ainsi que les vaisseaux obturateurs.

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References

  1. 1.
    Bergquist D, Carlsson AS, Ericsson BF (1983) Vascular complications after total hip arthroplasty. Acta Orthop Scand 54: 157–163Google Scholar
  2. 2.
    Dorr LD, Conaty JP, Kohl R, Harvey JP (1974) False aneurysm of the femoral artery following total hip surgery J Bone Joint Surg [Am] 56: 1059–1062Google Scholar
  3. 3.
    Mallory TH (1972) Rupture of the common iliac vein from reaming the acetabulum during total hip replacement. A case report. J Bone Joint Surg [Am] 54: 276–277Google Scholar
  4. 4.
    Wasielewski RC, Coopersterin LA, Kruger MP, Rubash HE (1990) Acetabular anatomy and the transacetabular fixation of screws in total hip arthroplasty. J Bone Joint Surg [Am] 72: 501–508Google Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • S. K. Hwang
    • 1
  1. 1.Department of Orthopaedic SurgeryYonsei University Wonju College of Medicine, Wonju Christian HospitalKangwon-Do, WonjuKorea

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