• Injury · Feb 2022

    Danger zone - The spermatic cord during anterior plating of the symphysis pubis.

    • Nina Hörlesberger, Gloria Hohenberger, Peter Grechenig, Angelika Schwarz, Christoph Grechenig, Martin Ornig, Ellen Tackner, and Axel Gänsslen.
    • Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria. Electronic address: nina.hoerlesberger@aon.at.
    • Injury. 2022 Feb 1; 53 (2): 519-522.

    BackgroundDistances between anatomic landmarks and anatomic structures at risk are often underestimated by surgeons.PurposeThe goal of the study was to evaluate the distances between anatomic landmarks and the spermatic cord in case of anterior plating of the symphysis.MethodsA total of 25 pelves (50 hemipelves) of male embalmed cadavers were dissected. A 5-hole 3.5mm locking compression plate (Synthes GmbH) was fixed from directly anterior on the symphysis. Measurements were taken 1) distance between the tips of both pubic tubercles, 2) horizontal interval between the lateral border of the plate and the medial margin of the SC (bilateral), 3) distances between the medial border of the SC and the tip of the pubic tubercle (bilateral), 4) distances between the medial border of the SC and the lateral basis of the pubic tubercle (bilateral).ResultsThe distance between the pubic tubercles was 60.3mm in average (SD: 5.7). The interval between the lateral border of the plate and the medial margin of the SC was on average 4.5mm (SD: 1.9) on the right and 4.7mm (SD: 2.6) on the left side. The distance between the tip of the pubic tubercle and the medial border of the SC was in average 11.2mm (SD: 2.7) on the right, and 11.0mm (SD: 2.7) on the left side. The average distance between the medial border of the SC and the lateral basis of the pubic tubercle was 8.1mm (SD: 2.4) on the right and 8.2 mm (SD: 2.4) on the left side.ConclusionThe SC is at risk not only during dissection but also during anterior plating of the symphysis, because of its close relation to the SC.Clinical RelevanceAverage distances between the palpable pubic tubercle and the SC are below one finger breadth (as reference).Copyright © 2021. Published by Elsevier Ltd.

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