臀上神经的应用解剖

Applied Anatomy of Superior Gluteal Nerve

为髋关节直接外侧入路确定臀上神经的体表投影和手术安全区 ,在 44侧的成人尸体标本上 ,解剖观测了与该入路关系紧密的臀上神经最下支分支的分布。结果手术入路的安全区为①在经大转子尖分别作与髂后上棘连线、髂嵴垂直连线、髂前上棘上方 3cm和髂前上棘连线 ,在这些连线上 ,最下支距大转子尖的距离分别为 5 5± 0 6、 4 8± 0 6、 4 3± 0 6、 6 4± 0 8cm ;②在经大转子外侧最凸点分别作与髂后上棘连线、髂嵴垂直连线、髂前上棘上方 6cm和 3cm的髂嵴连线 ,最下支距大转子外侧最凸点的距离分别为 1 0 0± 0 8、 9 0± 0 8、 7 5± 0 6、 8 9± 0 7cm。上述两组数值所在点作连线即分别为最下支神经的体表投影。结果表明 :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 ,在此区内撑开臀中。

To determine surface projection and safe region of superior gluteal nerve for the route to direct hip joint, distribution of the lowest branch of superior gluteal nerve connected closely with the route were dissected and observed on 44 sides of adult cadavers. The safe regions were 5 5±0 5cm to the acme of the greater trochanter on the line from the acme to the posterior superior iliac spine, 4 8±0 6cm to the acme on the line from the acme to rightly the iliac crest, 4 3±0 6cm to the acme on the line from the acme to the point 3cm above the anterior superior iliac spine, and 6 4±0 8cm to the acme on the line from the acme to the anterior superior iliac spine. The distances from the lateral protrusive point of greater trochanter to the posterior superior iliac spine, to the iliac crest, to the point 6cm and 3cm above the anterior superior iliac spine were respectively 10 0±0 8, 9 0±0 8, 7 5±0 6 and 8 9±0 7cm. The surface projection of the lowest branch was located on the line from above two digits. Few blood vessel and nerve branches were observed in the region below the surface projection. The superior gluteal nerve can not be injured when the middle and lesser gluteal muscle were opened to uncover acetabulum within this region.