Anagnostopoulou Sofia, Anagnostis George, Saranteas Theodosios, Mavrogenis Andreas F, Paraskeuopoulos Tilemachos
Orthopedics. 2016 Mar-Apr;39(2):e259-62. doi: 10.3928/01477447-20160129-03. Epub 2016 Feb 3.
Conflicting data exist regarding the anatomical relationship of the saphenous and infrapatellar nerves at the adductor canal and the location of the superior foramen of the canal. Therefore, the authors performed a cadaveric study to detail the relationship and course of the saphenous and infrapatellar nerves and the level of the superior foramen of the canal. The adductor canal and subsartorial compartment were dissected in 17 human cadavers. The distance between the superior foramen of the canal and the mid-distance (MD) between the base of the patella and the anterior superior iliac crest were measured; the course of the saphenous and infrapatellar nerves and the level of origin of the infrapatellar branch were detailed. In 13 of 17 specimens, the superior foramen of the adductor canal was distal to the MD (mean, 6.5 cm); in the remaining specimens, it was proximal to the MD. In 12 of 17 specimens, the infrapatellar branch exited the canal separately from the saphenous nerve; in the remaining specimens, it originated caudally to the canal. In all dissections, the infrapatellar branch had a constant course in close proximity to the saphenous nerve within the canal and between the sartorious muscle and femoral artery caudally to the canal. Most commonly, the superior foramen of the adductor canal is located caudally to the MD; the infrapatellar branch originates from the saphenous nerve within the canal and has a constant course in close proximity to the saphenous nerve. These observations should be considered for regional anesthesia techniques at the adductor canal.
关于隐神经和髌下神经在内收肌管的解剖关系以及该管上孔的位置，存在相互矛盾的数据。因此，作者进行了一项尸体研究，以详细阐述隐神经和髌下神经的关系及走行，以及该管上孔的水平位置。在17具人体尸体上解剖了内收肌管和缝匠肌下间隙。测量了该管上孔与髌骨底部和髂前上棘之间中点距离（MD）之间的距离；详细记录了隐神经和髌下神经的走行以及髌下支的起始水平。在17个标本中的13个中，内收肌管的上孔位于MD的远侧（平均6.5厘米）；在其余标本中，它位于MD的近侧。在17个标本中的12个中，髌下支与隐神经分开离开该管；在其余标本中，它起源于该管的尾侧。在所有解剖中，髌下支在管内以及在管尾侧的缝匠肌和股动脉之间紧邻隐神经走行恒定。最常见的情况是，内收肌管的上孔位于MD的尾侧；髌下支起源于管内的隐神经，并紧邻隐神经走行恒定。在内收肌管进行区域麻醉技术时应考虑这些观察结果。
