Anterior versus posterior pin placement of pelvic C-clamp in relationship to anatomical structures: a cadaver study.

Abstract

The objective of this study was to compare anterior and posterior pin placement of the pelvic C-clamp with specific reference to the proximity of the sciatic nerve, sciatic notch, hip joint capsule, and superior gluteal neurovascular bundle. The pelvic C-clamp (Synthes, Paoli, PA) was applied to eight extracted pelvic specimens and five full cadavers (26 hips in total). Anterior and posterior pin placements were measured in relationship to the described anatomical structures. In 100% of the hips the distance from the posterior pin to the hip joint capsule was in 21 (80.8%), 23 (88.5%), and 20 (76.9%) of the hips, the anterior pin distances were greater than the posterior pin distances to the sciatic nerve, sciatic notch, and superior gluteal neurovascular bundle, respectively. Anterior pin placement is further from all anatomical structures studies with the exception of the hip joint capsule. The posterior pin was closer to the sciatic nerve, sciatic notch, and superior gluteal neurovascular bundle in all cases. Clinical decision-making for C-clamp placement should be individualised on a case-by-case basis.