微创后外侧入路全髋关节置换的应用解剖

祝宗华, 郭涛, 徐文联, 李华杰, 张发惠, 郑和平

中国临床解剖学杂志 ›› 2009, Vol. 27 ›› Issue (6) : 654.

中国临床解剖学杂志 ›› 2009, Vol. 27 ›› Issue (6) : 654.
应用解剖

微创后外侧入路全髋关节置换的应用解剖

  • 祝宗华1, 郭 涛2, 徐文联1, 李华杰1, 张发惠3, 郑和平3
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Applied anatomy of the total hip arthroplasty through the minimally invasive posterolateral approach

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摘要

  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。

Abstract

        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.

关键词

髋关节 / 关节置换 / 微创 / 后外侧切口 / 应用解剖

Key words

hip / arthroplasty / minimal invasion / posterolateral approach / applied anatom

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祝宗华, 郭涛, 徐文联, 李华杰, 张发惠, 郑和平. 微创后外侧入路全髋关节置换的应用解剖[J]. 中国临床解剖学杂志. 2009, 27(6): 654
CHU Zong-Hua, GUO Chao, XU Wen-Lian, LI Hua-Jie, ZHANG Fa-Hui, ZHENG He-Beng. Applied anatomy of the total hip arthroplasty through the minimally invasive posterolateral approach[J]. Chinese Journal of Clinical Anatomy. 2009, 27(6): 654
中图分类号:      R323.44    R322.72   

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