臀上神经最下支的解剖定位及其在髋关节外侧入路中意义

The course of the lowest branch of superior gluteal nerve and its signifi-cance in the direct lateral approach to the hip

密切结合髋关节直接外侧入路，在２２具（４４侧）成人尸体标本上，重点解剖观测了与该入路关系紧密的臀上神经最下支的走行、入肌点，体表投影和安全区。①在以大转子尖分别作与髂后上棘连续、髂嵴垂直连线、髂前上棘上沿３ｅｍ处髂嵴和髂前上棘连线上，最下支距大转子尖平均分别为５．５±０．６、４．８±０．６、４．３±０．６、６．４±０．８ｃｍ；②在以大转子外侧最凸点分别作与髂后上棘连线、髂嵴连线、髂前上棘上沿６ｃｍ和３ｃｍ处髂嵴连续上，最下支距大转子外侧最凸点平均分别为１０．０±０．８、９，Ｏ士０．８、７．５±０．６、８．９±０．７ｃｍ。上述两组数值所在点作连线即为最下支神经的体表投影，投影以下至大转子尖或大转子外侧最凸点之间无明显血管神经分布，为手术入路的安全区，在安全区内撑开臀中、小肌肌纤维显露髋臼均不会损伤臀上神经。

he course. surface projection and safe region of the lowest branch of superior gluteal nerve. which Was connected closely with lateral direct apporach to the hip ioint. were dissected and ob-served in 22 cases(44 sides)of adult cadavers. The surface projection points of the lowest branchare 5. 5±0.6 cm to the ace of the greater trochanter on the line from the acme to the posterior;su-perior iliac spine,4.8±0; 6 cm to the acme on the line from the acme to the iliac crest,4.3±0.6cm to the acme on the line from the acme to the point 3 cm above the anterior superior iliac spine. and 6.4±0.8 cm to the acme on the line from the acme to the anterior superior iliac spine,Somecourse of sruface projection of the nerve branch could be drawn if the lateral protrusive point ofgreater trochanter was chosen as surface mark. Few blood vessel and nerve branches were ob-scrved in the region below the surface projection,which is a safe lateral approach to the hip.