Supraacetabular osseous corridor: defining dimensions, sex differences, and alternatives

Area of Science:

• Orthopedic surgery
• Anatomy
• Medical imaging

Background:

• The supraacetabular (SA) corridor is crucial for stabilizing pelvic and acetabular fractures.
• Quantitative analysis of the SA corridor's dimensions is lacking.
• Understanding its characteristics is vital for safe implant placement.

Purpose of the Study:

• To define the dimensions and characteristics of the SA corridor.
• To identify common constriction points within the SA corridor.
• To explore alternative trajectories that maximize the SA corridor's diameter.

Main Methods:

• Computed tomography (CT) scans of 200 hemipelves (100 male, 100 female) without trauma were analyzed.
• Manual best-fit analysis determined corridor boundaries.
• Alternative trajectories were tested to find the maximal intercortical cylinder diameter.

Main Results:

• The traditional SA corridor averaged 8.3 mm in men and 6.2 mm in women.
• Women's narrower corridor is attributed to a more S-shaped ilium.
• An alternative SA corridor measured 11.3 mm in men and 9.9 mm in women, showing significant increases.

Conclusions:

• The traditional SA corridor is adequate for most hardware in men but restricted in women.
• An alternative SA corridor provides a significantly larger diameter in both sexes.
• Consider the alternative SA corridor for larger implants, particularly in women.