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

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The supraacetabular (SA) corridor extends from the anterior inferior iliac spine to the posterior ilium and can safely accommodate implants to stabilize pelvic and acetabular fractures. However, quantitative analysis of its dimensions and characteristics have not been thoroughly described. This study seeks to define the dimensions, common constriction points, and any alternative trajectories that would maximize the corridor diameter.

Methods

Computed tomography of 100 male and 100 female hemipelves without osseous trauma were evaluated. The corridor boundaries were determined through manual best-fit analysis. The largest intercortical cylinder within the pathway was created and measured. Alternative trajectories were tested within the SA boundaries to identify another orientation that maximized the diameter of the intercortical cylinder.

Results

The traditional SA corridor had a mean diameter of 8.3 mm in men and 6.2 mm in women. This difference in diameter is due to a more S-shaped ilium in women. A larger alternative SA corridor was found that had a less limited path through the ilium and measured 11.3 mm in men and 9.9 mm in women. These dimensions are significantly different compared to those of the traditional SA corridor in both men and women.

Conclusions

In men, the SA corridor allows for the safe passage of most hardware used in pelvic and acetabular fractures. However, in women, the SA corridor is restricted by a more S-shaped ilium. An alternative trajectory was found that has a significantly larger mean diameter in both sexes. Ultimately, the trajectory of hardware will be dictated by the clinical scenario. When large implants are needed, especially in women, we recommend considering the alternative SA corridor.

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Authors and Affiliations

  1. Department of Orthopaedics and Rehabilitation, University of Vermont, 4th Floor Safford Hall, 95 Carrigan Dr., Burlington, VT, 05405, USA

    Miqi Wang, Craig S. Bartlett & Patrick C. Schottel

  2. Department of Orthopaedic, Surgery University of Minnesota, 2450 Riverside Ave South, R200, Minneapolis, MN, 55454, USA

    Robert C. Jacobs

Authors
  1. Miqi Wang
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  2. Robert C. Jacobs
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  3. Craig S. Bartlett
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  4. Patrick C. Schottel
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Correspondence to Miqi Wang.

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Conflict of interest

Miqi Wang is a stockholder in Johnson and Johnson. Robert C. Jacobs declares that he has no conflicts of interest. Craig S. Bartlett has received teaching honoraria from AO Trauma and is a consultant for and stockholder in DePuy-Synthes, SI Bone, Pelvixx, and Summate Technology. Patrick C. Schottel is a paid consultant for Synthes.

Ethical review committee statement

This study was found to be exempt by our institution’s IRB committee. All the work was performed at University of Vermont Medical Center.

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Wang, M., Jacobs, R.C., Bartlett, C.S. et al. Supraacetabular osseous corridor: defining dimensions, sex differences, and alternatives. Arch Orthop Trauma Surg 142, 1429–1434 (2022). https://doi.org/10.1007/s00402-021-03786-3

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  • DOI: https://doi.org/10.1007/s00402-021-03786-3

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