Evaluation of the superior pubic ramus and supra acetabular corridors using statistical shape modelling

Surg Radiol Anat. 2024 Aug;46(8):1189-1197. doi: 10.1007/s00276-024-03420-y. Epub 2024 Jun 28.

Abstract

Introduction: The incidence of osteoporotic pelvic fractures is increasing. The broken anterior pelvic ring is preferentially fixed with long intramedullary screws, which require a good understanding of the patient-specific anatomy to prevent joint perforation. The aim of this study was to assess the variability of the superior pubic ramus and the supra acetabular corridors' length and width using statistical shape modelling.

Materials and methods: A male and female statistical shape model was made based on 59 forensic CT scans. For the superior pubic ramus and the supra acetabular corridor the longest and widest completely fitting cylinder was created for the first 5 principal components (PC) of both models, male and female pelvises separately.

Results: A total of 59 pelvises were included in this study of which 36 male and 23 female. The first 5 principal components explained 75% and 79% of the pelvic variation in males and females, respectively. Within 3 PCs of the female statistical shape model (SSM) a superior pubic ramus corridor of < 7.3 mm was found, 5.5 mm being the narrowest linear corridor measured. Both corridors in all PCs of the male SSM measured > 7.3 mm.

Conclusion: Within females a 7.3 mm and 6.5 mm screw won't always fit in the superior pubic ramus corridor, especially if a flat sacrum, a small pelvis or a wide subpubic angle are present. The supra acetabular corridor did not seem to have sex-specific differences. In the supra-acetabular corridor there was always enough space to accommodate a 7.3 mm screw, both in males and females.

Keywords: Anatomical variation; Fracture; Pelvis; Principal component analysis; Statistical shape modeling.

MeSH terms

  • Acetabulum* / anatomy & histology
  • Acetabulum* / diagnostic imaging
  • Adult
  • Aged
  • Aged, 80 and over
  • Anatomic Variation
  • Bone Screws
  • Female
  • Fractures, Bone / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical
  • Pelvic Bones / anatomy & histology
  • Pelvic Bones / diagnostic imaging
  • Pubic Bone* / anatomy & histology
  • Pubic Bone* / diagnostic imaging
  • Tomography, X-Ray Computed*