[Variations of superficial nerves at the pelvis considering orthopaedic surgical approaches]

Intraoperative injuries of vessels and nerves are common risks and repeatedly described in orthopaedic pelvic surgery. Especially in pelvic osteotomies or bone harvesting procedures subcutaneous nerves are at risk for damage. In this study we elucidated the variations of subcutaneous nerves by anatomic preparation exposure with regard to the anterior and posterior spines.

To investigate the different anatomic variations the iliohypogastrical, lateral cutaneous, subcostal and the cluneal nerves of 10 human cadavers were prepared and exposed bilaterally at the anterior, lateral and posterior pelvic region. For determination of anatomically important reference points the distance of these structures to the anterior superior spine was measured and compared with present datas in literature with respect to the ilioinguinal (Letournel) and iliofemoral (Smith- Petersen) approach.

We found a high variability of superficial pelvic nerves. Our findings differ somehow with datas of recent papers.

The findings of our study stress the importance of basic knowledge and thorough preparation in surgical procedures at the pelvis including harvesting bone grafts to minimize donor site morbidity.