Anatomy Of The Acetabulum - Everything You Need To Know - Dr. Nabil Ebraheim

anatomy of the

columns of the establish will divides

the establish to an anterior and a

posterior column which becomes important

when considering establish raksha's and

their management

Thank You column is composed of the

anterior ilium the interior wall and

dome of the establish a superior pubic


the posterior column extend from the

operator framing through the posterior

aspect of the weight bearing Dome of the

establish an obliquely through the

greater sciatic notch

the issue of pubic ramus is a complex

structure that consists of the inferior

pubic ramus and inferior ramus of the

ischium it forms the inferior border of

the operator of Freeman

the pelvis is oriented to form an

inverted Y shape

important vascular Anatomy the obturator


the operator Artie is a branch of the

anterior division of the internal iliac


it arises in the pelvis and it enters

our trato canal

and it divides into two branches the

anterior and the posterior branch which

form a vascular circle around the outer

surface of the obturator membrane

Anna Stabler branch which reaches the

hip joint joins the ligamentum teres to

supply the head of the femur usually a

small portion of the head of the femur

mortis is a connection between the

internal iliac branch the operator and

external iliac or its branch then feel

your abs tricked

it is predominantly a venous connection

and the arterial connection is much less

to location and disappear pubic ramus is

variable it's about three to seven

centimeter from the symphysis pubis

it is located behind and on top of the

superior pubic ramus

and one must be careful with lateral

dissection of the superior pubic ramus a

coronal mortise it's susceptible to

injury in bilva trauma and pelvic

surgery especially during the a leo

inguinal approach

the injury to the corona mortis may lead

to significant hemorrhage which may be

difficult to control

superior gluteal artery the superior

gluteal artery passes through the

greater sciatic notch injury to the

superior gluteal artery can be

associated with establish axons

especially fractures that involve the

posterior column

our tree can be damaged by aggressive

the attraction of the abductor muscles

during posterior approach

the medial femoral circumflex it can be

damaged from dislocation of the femoral

head or from taking down the quadratus

from the femur instead of the ischium

you need to leave a tag of one

centimeter for the piriformis and the

obturator internus from the greater

trochanter to preserve the deep branch

of the medial femoral circumflex artery

if you detach these two tendons too

close to the two Kenter you could injure

the deep branch of the medial femoral

SiC complex

the medial femoral circle flex it the

main blood supply to the femoral head

the sciatic nerve is close to the

establish a me injured in fact

Sadek nerve injury in the most common

traumatic and atherogenic nerve injury

connected to this problem

this nerve injury can be approximately

10% with help dislocation the incidence

may be higher with posterior establish


when we examined a patient with an

establish or all check the setting their


check those deflection of the ankle and

the toes it is the premier division that

will be affected

check for numbness at the top of the


repeat the exam again just before

surgery partial setting nerve injury can

get worse from established surgery

the Santa Clara Anatomy is variable but

we'll describe there might be variation

in its anatomy and here these diagrams

shows the insolence of the most common

pattern of the relationship between the

setting nerve and the piriformis muscle

be aware that the nerve can be split and

that can be normal

keep the knee flexed and the hip

extended during posterior approach to

the establish Attic nerve

the sciatic nerve is posterior to the

operator internists and endeared to the


when using the static nerve retractor in

the lesser sciatic notch the muscle and

the tendon of the operative interests

protect the nerve

it act as a buffer layer between the

retractor and enough because the nerve

is posterior to the muscle

you can take osteotomy allows exposure

of the dome and the superior aspect of

the establish this type of osteotomy

keep the muscles intact and this will

balance its pulling forces

it will be less of a chance of

displacement of the greater trochanter

this way

super gluteal nerve is close to the

spiritual artery at the greater sciatic


the superior gluteal nerve can be

injured from approaches that involve

more than five centimeter above the

excessive traction or attempt to control

the bleeding from the superior gluteal

artery at the greater sciatic notch may

injure the nerve by a suture or by a

vascular clip that may entangle the


to this nerve me affect the gluteus

medius and minimus

injury of this nerve affects the

abductors of the hip and the patient may

end up with a Trendelenburg gait

then filled gluteal nerve also may be

angel it innervates the gluteus maximus


the lateral cutaneous nerve of the thigh

can be injured during an emu internal


this neighbor usually passes under the

Elio inguinal ligament about two

centimeter medial to the anterior

superior iliac spine

thank you very much I hope that was