A Modified Levine Approach for Exposure of the Anterior Column, Anterior Wall, and Sacroiliac Joint: A Surgical Technique and a Case Series. Issue 12 (December 2021)

• Record Type: Journal Article
• Authors: Jang, Yohan; Virkus, Walter; Mckinley, Todd
• Is Part Of: Journal of orthopaedic trauma. Volume 35:Issue 12(2021)
• Publication Date: 2021-12
• Subjects: technical trick -- acetabulum -- pelvis; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000002111
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Summary: Surgical exposure of the anterior column, anterior wall, pelvic brim, and sacroiliac joint is accessible through the lateral window of the ilioinguinal approach. Residual attachment of the abdominal muscles and inguinal ligament to the anterior superior iliac spine (ASIS) is often a limiting factor to expanded distal and medial exposure, especially in patients with a large abdomen that hangs over the pelvis. An ASIS osteotomy has been described to improve exposure, particularly of the distal anterior wall and joint capsule, pubic ramus, and anterior quadrilateral plate. However, an ASIS osteotomy can be troublesome to reattach. In this study, we introduce a soft tissue release technique to mobilize the abdominal muscles and inguinal ligament to allow expanded surgical access to the distal anterior column/wall and sacroiliac joint and to create a working space for fracture reduction and fixation. Abstract : Supplemental Digital Content is Available in the Text.