Large pelvic tubercle in orangutans relates to the adductor longus muscle

Orangutan pelves commonly exhibit a large, projecting tubercle in the iliopubic region, historically assumed to homologous to the pubic tubercle in humans. However, it is not clear whether this tubercle is a unique feature of Pongo, or if it is anatomically homologous with the human pubic tubercle when considered as a soft tissue attachment point. To clarify this issue, we dissected orangutan and other ape cadaveric specimens to evaluate the pelvic brim soft tissues and how they may relate to the tubercle (when present). We additionally conducted a broad osteological survey of pelvic brim morphology across 28 primate genera (n = 294 specimens) to document the presence of the tubercle in primate pelves. Cadaveric dissections revealed that the tubercle is exclusively associated with the proximal attachment of the adductor longus muscle tendon in orangutans. Our osteological survey confirms that the tubercle is both constantly present and very prominent in orangutans. We observed that the tubercle is consistently situated along the pectineal line, lateral to where the pubic tubercle in humans is found, thereby making its structural homology unlikely. The osteological survey documented the tubercle at polymorphic frequencies in all hominoid taxa, though generally less protuberant than observed in Pongo. We argue that this further excludes its possibility of homology with the pubic tubercle, and that it may therefore be more appropriately be considered an adductor longus tubercle. We discuss possible functional and phylogenetic implications for this feature.

Insertion of psoas minor tendon at pelvic brim, a novel anatomic landmark for extra-articular, screw placement through Stoppa approach

BACKGROUND

The psoas minor partially inserted to the superior pelvic brim. And the plate used to fix the acetabular fracture has always been positioned at the pelvic brim after reduction through the Stoppa approach. However, there are few studies depicting the clinical significance of the psoas minor. The purpose of this paper was to explore the relationship between the insertion of the psoas minor tendon at the pelvic brim (IPMTPB) and screw placement through the Stoppa approach.

MATERIALS AND METHODS

Fifteen cadavers were dissected for adequate exposure to IPMTPB in our study. However, not all specimens had a psoas minor. For the specimens with IPMTPB, the posterior and anterior edges were used as the first and second entry points, dividing the area from the sacroiliac joint to the pubic symphysis into three zones (d1, d2 and d3). The average proportion of each zone was obtained after measurement the three zones, to locate the two entry points for the specimens without a psoas minor. From the longitudinal Stoppa incision, the first wire was inserted horizontally, and the second wire was placed vertical to the bone surface. Fluoroscopy and computed tomography (CT) were conducted to examine the relationship between the wires and the acetabulum.

RESULTS

There was a psoas minor in sixteen hemipelvises (53.33%). After measurement and calculation, we determined that the average proportions of zones d1, d2, and d3 were 28.03%, 29.14%, and 42.83%, respectively. For all specimens, the wires were successfully inserted, and the trajectories of the wires were outside the hip joint cavity.

CONCLUSIONS

IPMTPB could be used as an anatomic landmark of safe zones for screw placement through the Stoppa approach. For cases without a psoas minor, the zones for extra-articular screw placement could be determined through the measurements in this paper.