微创后外侧入路全髋关节置换的应用解剖
Applied anatomy of the total hip arthroplasty through the minimally invasive posterolateral approach
目的:为微创后外侧入路全髋关节置换的体表定位提供解剖学依据。方法:解剖观察30侧成人臀区标本, 以同侧股骨大转子外侧缘最突出点(A点)与髂后上棘沿髂嵴向前3.0 cm处(C点)作连线,A点与C点连线的中点处为B点,A、B两点连线即为所设计的长8.0 cm微创全髋关节置换后外侧入路切口。了解臀上动、静脉、神经与臀下动、静脉、神经及坐骨神经和微创后外侧入路切口的解剖关系。结果:臀上神经及臀上动、静脉在梨状肌上孔处距切口的距离为(3.69±0.79)cm,臀下神经及臀下动、静脉在梨状肌下孔处距切口的距离为(5.83±1.21)cm,坐骨神经在梨状肌下孔以下距切口最近距离为(4.09±0.66)cm。结论:微创后外侧入路切口可有效避开重要神经血管,解剖学骨性标志定位简捷。
Objective: To provide anatomic evidences for minimally invasive surgery of total hip arthroplasty through the posterolateral approcach. Methods: Gluteal region of 30 adult specimens were dissected and observed. A line was drawn between the highest point of the greater trochanter of femur's lateral border (point A) and the point 3 cm ahead of the posterior superior iliac spine (point C), while the middle point of the AC line was taken as point B. The line between A and B was minimally invasive incision, with the length of 8.0 cm, for total hip arthroplasty through the posterolateral approach. The relevant anatomic features dealing with minimally invasive incision, including superior/inferior gluteal vessels and nerves and sciatic nerve were dissected and analyzed. Results: At the site of suprapitiform foramen, the distance between the superior gluteal vessels and nerves and the insicion was about (3.69±0.79)cm, however, at the site of infrapiriform foramen, the distance between the inferior gluteal vessels and nerves and the incision was (5.83±1.21)cm. The nearest distance from sciatic nerve to the incision below the infrapiriform foramen was about (4.09±0.66)cm. Conclusions: It is reliable to protect important nerves and vessels of gluteal area adopting minimally invasive posterior lateral approach. It is easy to locate bony markers during the operation.
髋关节 / 关节置换 / 微创 / 后外侧切口 / 应用解剖
hip / arthroplasty / minimal invasion / posterolateral approach / applied anatom
/
〈 |
|
〉 |