The surgeon should access the medial window that is created by dissection of the iliopectineal
fascia and retraction of the adjacent structures.
Anatomical restoration, however, remains cumbersome for several reasons: (i) the fracture located in the false and true pelvis impeding visualization and access of the fracture lines; (ii) osteopenia with a poor bone stock and insufficient partial weight bearing of the treated limb in elderly patients raising the risk for failure of the osteosynthesis with secondary loss of reduction; (iii) risk of penetration of the hip joint by screws around the iliopectineal
eminence with consecutive development of secondary osteoarthritis.
(Cooper's) ligament a thickening in the periosteum of the pubic bone is used to anchor the sutures in the Burch retropubic bladder neck suspension.
(3) Ventral transverse diameter: diameter between the iliopectineal
The classic syndrome, termed coxa saltans interna, occurs when the iliopsoas tendon catches on the iliopectineal
eminence or snaps across the femoral head with hip motion from flexion to extension.
In patients with hip pain and bursitis, applying downward pressure will elicit a snapping sound as the iliopsoas snaps over the iliopectineal
eminence or femoral head.
Two important bursae may lead to hip pain: iliopectineal
and greater trochanteric bursa.
The second osteotomy is the complete separation of the pubic bone medial to the iliopectineal
eminence; during this osteotomy, the obturator nerve and vessels have to be protected with blunt retractors.
These lines are: the iliopectineal
line which is formed by the anterior column of the acetabulum, the ilioischial line which is formed by the posterior column of the acetabulum, the anterior and posterior lips of the acetabulum (Solomon et al 2001, Wheeless 2008).
(3) Paget disease of the pelvis will demonstrate cortical thickening and sclerosis of the iliopectineal
and ischiopubic lines, as well as an enlarged ileac wing, which is asymmetric and more common on the right side.
It is inserted by a long flat tendon attached to iliopectineal
eminence, pectineal line and iliac fascia.
* Internal snapping is related to the iliopsoas tendon passing over the femoral head and hip capsule or over the iliopectineal
eminence and bony ridge of the lesser trochanter.