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Osteology of the ilium revised: illuminating the clinical relevance

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Background

Several studies on anterior and posterior pelvic ring fixation have identified a fragile monocortical area located at the iliac wing. However, there are no current studies regarding this structure’s dimensions and relation to known anatomic structures.

Methods

Eleven human ilia were dissected from 6 specimens. After debulking soft tissue, photoluminescence was used to indicate the fragile area. The size and thickness of the iliac wing were determined and mapped in relation to the anterior superior iliac spine (ASIS) and the posterior superior iliac spine (PSIS).

Results

This photoluminescent unicortical area measured 15.57 cm2 with a mean minimal thickness of 1.37 mm at its thinnest part. Its average diameter was 41.15 mm horizontally and 37.45 mm vertically. In all cases, it was located at the middle third of the ilium with a mean distance of 64.58 mm to the AIIS and 62.73 mm to the PSIS. Trajectory angulation above 4.5° from the PSIS lead to violation of this area.

Conclusion

This study provides useful anatomical information regarding a thin unicortical area at the iliac wing that is relevant to anterior and posterior pelvic ring fixation and the potential complications that can arise from iatrogenic perforation of this area.

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Authors and Affiliations

  1. Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, USA

    Alexander von Glinski, Sven Frieler, Basem Ishak, Ryan Goodmanson, Jens R. Chapman, Rod J. Oskouian & R. Shane Tubbs

  2. Seattle Science Foundation, Seattle, WA, USA

    Alexander von Glinski, Sven Frieler, Basem Ishak, Ryan Goodmanson, Joe Iwanaga & Rod J. Oskouian

  3. Department of Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany

    Alexander von Glinski, Sven Frieler, Emre Yilmaz & Thomas A. Schildhauer

  4. Hansjörg Wyss Hip and Pelvic Center, Swedish Hospital, Seattle, WA, USA

    Alexander von Glinski, Sven Frieler & Keith Mayo

  5. Department of Anatomical Sciences, St. George’s University, St. George’s, Grenada

    R. Shane Tubbs

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  1. Alexander von Glinski
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  2. Sven Frieler
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  3. Emre Yilmaz
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  4. Basem Ishak
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  6. Joe Iwanaga
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  7. Thomas A. Schildhauer
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Contributions

A.v.G, S.F, E.Y, B.I, R.G, J.C, T.A.S, K.M, R.O, J.I and S.T contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript.

Corresponding author

Correspondence to Sven Frieler.

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The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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von Glinski, A., Frieler, S., Yilmaz, E. et al. Osteology of the ilium revised: illuminating the clinical relevance. Eur J Trauma Emerg Surg 47, 1671–1677 (2021). https://doi.org/10.1007/s00068-020-01482-2

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  • DOI: https://doi.org/10.1007/s00068-020-01482-2

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