髋关节神经支配的解剖学研究及其临床意义

Anatomy study on nervous ramification to hip joint and its clinical significance

目的:为髋关节去神经术提供解剖学依据。方法:在54侧成人尸体下肢标本上,对支配髋关节的神经支进行解剖观测。结果:①股神经耻骨肌支位于腹股沟韧带中点下约2.3 cm处,起自股神经内侧,横径约1.3 mm,向内下走行,穿经股动、静脉深面进入耻骨肌;②坐骨神经股方肌支于梨状肌下缘稍上方,自坐骨神经深面发出,沿孖肌深面内侧下行,至股方肌上缘水平发一髋关节支,股方肌支主干下行进入股方肌内;③闭孔神经前支主干在出闭膜管外口后向外侧发1支耻骨肌支和2支关节支,闭孔神经后支主干在出闭膜管外口后向外侧发1关节支。结论:支配髋关节的3个来源的神经支及其分支均具有解剖位置恒定,容易显露和手术创伤小等特点。

Objective: To provide the anatomical basis for neurectomy of hip joint. Methods: Nervous ramification to hip joint was dissected and observed on 54 sides of adult cadaveric lower limb specimens. Results: ① Located at 2.3cm below the middle of inguinal ligament, pectineus branch of femoral nerve originated from medial part of femoral nerve with diameter 1.3mm, and went medial-downward to pectineus muscle through femoral vessel; ② Quadratus femoris branch of sciatic nerve originated from deep part of sciatic nerve above inferior border of piriformis muscle and went deeply along the medial part of gemellus muscle group, when reaching the level of superior border of quadratus femoris muscle, it sent off one nervous ramification to hip joint capsule and entered quadratus femoris muscle in the end; ③ Departing from the external opening, obturator nerve anterior branch sent off one pectineus branch and two articular branches, while obturator nerve posterior branch sent off one articular branch. Conclusions: The anatomical position of three nerves and their branches to hip joint was constant, so the exposure of neurectomy can be done easily and the operation injury can be minimized.