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小儿髋关节镜检查:神经血管解剖结构与入路途径的关系

Infantile hip arthroscopy: the relationship between neurovascular anatomy and the portal pathway.

作者信息

Chanlalit Cholawish, Saisongcroh Tanyawat, Raksakulkiat Rattavuth, Torudom Yingyong

机构信息

Department of Orthopedics, Faculty of Medicine, HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakhrinwirot University, Nakhon Nayok, Thailand.

出版信息

J Med Assoc Thai. 2009 Dec;92 Suppl 6:S156-60.

Abstract

OBJECTIVE

In the past, studies of hip arthroscopy portal path relate with extra-articular structures were done in adults. This study was investigated in the infantile group.

MATERIAL AND METHOD

10 hips of fresh infantile cadavers. K-wire diameter 2.4 mm. are representing scope pathway. Three portals (anterior, anterolateral and posterolateral) in supine position without traction were chose to used in this study.

RESULTS

One cadaver was female and four were male. The mean age and weight when death occurred was 74 days and the mean weight was 3584.4 gm. At the anterior portal, the most lateral branch of LFCN was frequently injured. The average distant of femoral nerve to the K-wire was 11.2 (7-14) mm. Transverse branch of lateral femoral circumflex artery had an average distant 8.5(6-14) mm and the terminal branch could be identified in four hip and average distance was 1 mm. At the anterolateral portal two, greater trochanter were injured by K-wire. In the posterolateral portal the average distant from K-wire to sciatic nerve was 13.2 mm.

CONCLUSION

From this pilot study, the distance of major neurovascular structure as related to hip scope path is nearly a centimeter on average.

摘要

目的

过去,关于髋关节镜入路与关节外结构关系的研究是在成人中进行的。本研究针对婴儿组展开。

材料与方法

选取10例新鲜婴儿尸体的髋关节。用直径2.4毫米的克氏针代表镜检路径。本研究选择在仰卧位且无牵引的情况下使用三个入路(前侧、前外侧和后外侧)。

结果

1具尸体为女性,4具为男性。死亡时的平均年龄和体重分别为74天和3584.4克。在前侧入路,股外侧皮神经最外侧分支常受损伤。股神经与克氏针的平均距离为11.2(7 - 14)毫米。旋股外侧动脉横支的平均距离为8.5(6 - 14)毫米,其终末支在4个髋关节中可被识别,平均距离为1毫米。在前外侧入路2处,克氏针损伤了大转子。在后外侧入路,克氏针与坐骨神经的平均距离为13.2毫米。

结论

通过这项初步研究,主要神经血管结构与髋关节镜路径的距离平均接近1厘米。

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