隐神经卡压征的临床解剖学研究

Clinical Anatomy of Saphenous Nerve Entrapment

目的 :探讨隐神经卡压征的解剖学基础。方法 :利用 2 0具成人尸体和 1 5条游离下肢 ,解剖、观测了隐神经在股部穿收肌腱板裂孔和在膝部穿缝匠肌—股薄肌下端间隙处的形态参数 ,并定位。结果 :在股部的收肌腱板裂孔处 ,隐神经宽 (2 .7± 0 .4)mm ,厚(1 .2± 0 .3)mm(厚 /宽 :0 .46) ;裂孔宽 (5 .2± 0 .7)mm ,高 (1 4 .1± 2 .4)mm ,孔远大于穿行其内的隐神经。在膝部的缝匠肌—股薄肌腱间隙处 ,神经宽 (2 .2± 0 .3)mm ,厚 (0 .8± 0 .2 )mm(厚 /宽 :0 .37) ;膝部隐神经更扁薄 ,且当膝关节屈伸时 ,神经在缝匠肌—肌薄肌间隙中受挤压 ,并与两肌内面的腱组织产生摩擦。另为隐神经卡压征的定位提供了一些参数。结论 :就股部收肌腱板裂孔和膝部缝匠肌—股薄肌间隙而言 ;隐神经更易在膝部的肌间隙内受挤压和摩擦而损伤。

Objective:To investigate anatomical basis of saphenous nerve entrapment.Methods:In 20 cadavers and 15 lower limbs,saphenous nerve were observed,measured and located in the positions of the nerve corssing the compact tissue.Results:In the position of saphenous nerve corssing the hole of anterior wall of adductor canal in the thign,the nerve was 2.7±0.4mm in width and 1.2±0.3mm in thickness.Being 5.2±0.7mm in width and 14.1±2.4mm in hightness,the hole was much larger than the nerve in it in diameter.In the slit between the tendons of satorius and gracilis in the knee,the nerve was 2.2±0.3mm in width and 0.8±0.2mm in thickness,saphenous nerve was thicker in the knee(thickness/width:0.37)than in the thigh(thickness/width:0.46).The nerve was so closed to the tendons of satorius and gracilis that friction occurred among the nerve and tendons when the knee flexed and extended.Some results of nerve location were put forward for the diagnosis and treatment of saphenous nerve eatrapment.Conclusion:The saphenous nerve was entrapped more possibly in the slit between the tendons of satorius and gracilis in the knee than in the hole of anterior wall of adductor canal in the thigh.