Department of Anatomy, University of Otago, Dunedin, 9054, New Zealand.
Clin Anat. 2014 Mar;27(2):241-53. doi: 10.1002/ca.22248. Epub 2013 Apr 27.
The anatomy of the hip abductors has not been comprehensively examined, yet is important to understanding function and pathology in the gluteal region. For example, pathology of the hip abductor muscle-tendon complexes can cause greater trochanteric pain syndrome, and may be associated with gluteal atrophy and fatty infiltration. The purpose of this study was to investigate the detailed morphology of gluteus medius (GMed), gluteus minimus (GMin), and tensor fascia lata (TFL), and determine whether the muscles comprised anatomical compartments. The gluteal region from 12 cadavers was dissected and data collected on attachment sites, volume, fascicular and tendinous anatomy, and innervation. Three sites of GMed origin were identified (gluteal fossa, gluteal aponeurosis, and posteroinferior edge of the iliac crest) and the distal tendon had lateral and posterior parts. GMed was the largest in volume (27.6 ± 11.6 cm(3); GMin 14.1 ± 11.1 cm(3); TFL 1.8 ± 0.8 cm(3)). Fascicles of GMin originated from the gluteal fossa, inserting onto the deep surface of its distal tendon and the hip joint capsule. TFL was encapsulated in the fascia lata, having no bony attachment. Primary innervation patterns varied for GMed, with three or four branches supplying different regions of muscle. Distinct secondary nerve branches entered four regions of GMin; no differential innervation was observed for TFL. On the basis of architectural parameters and innervation, GMed, and GMin each comprise of four compartments but TFL is a homogenous muscle. It is anticipated that these data will be useful for future clinical and functional studies of the hip abductors.
髋外展肌的解剖结构尚未得到全面检查,但对于理解臀部的功能和病理学非常重要。例如,髋外展肌-肌腱复合体的病理学可引起大转子疼痛综合征,并且可能与臀肌萎缩和脂肪浸润有关。本研究的目的是研究臀中肌(GMed)、臀小肌(GMin)和阔筋膜张肌(TFL)的详细形态,并确定这些肌肉是否包含解剖学隔室。从 12 具尸体中解剖了臀部区域,并收集了附着部位、体积、肌束和肌腱解剖以及神经支配的数据。确定了 GMed 的三个起源部位(臀窝、臀筋膜和髂嵴后下边缘),其远端肌腱有外侧和后侧两部分。GMed 的体积最大(27.6±11.6 cm³;GMin 为 14.1±11.1 cm³;TFL 为 1.8±0.8 cm³)。GMin 的肌束起源于臀窝,插入其远端肌腱和髋关节囊的深部表面。TFL 被包裹在阔筋膜中,没有骨附着。GMed 的初级神经支配模式不同,有三个或四个分支供应肌肉的不同区域。TFL 没有观察到明显的差异神经支配。根据结构参数和神经支配,GMed 和 GMin 各包含四个隔室,但 TFL 是一个同质的肌肉。预计这些数据将对未来髋关节外展肌的临床和功能研究有用。