Smitham Peter J, Kosuge Dennis, Howie Donald W, Solomon Lucian B
Discipline of Orthopaedics, The University of Adelaide, Adelaide - Australia.
Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide - Australia.
Hip Int. 2016 May 16;26(3):307-9. doi: 10.5301/hipint.5000350. Epub 2016 Apr 12.
The posterior approach to the hip is the most common extensile approach used, however exposure is limited superiorly by the superior gluteal neurovascular bundle (SGNB). The extra-pelvic course of the SGNB demonstrates variability between individuals, occasionally located only 1 cm from the acetabular rim. In complex acetabular reconstructions where the application of a reinforcement cage maybe required protecting the SGNB is challenging. The flanges of these cages are designed to sit on the ilium superior to the acetabular rim and to receive screws for fixation. The application of such cages may result in iatrogenic injury to the SGNB by way of forceful retraction or entrapment. We describe a technique that involves exposure and release of the SGNB such that the flanges of cage constructs may be safely applied.
髋关节后路是最常用的广泛暴露入路，然而，臀上神经血管束（SGNB）在上方限制了暴露范围。SGNB在骨盆外的走行在个体间存在差异，偶尔距离髋臼边缘仅1厘米。在可能需要应用加强笼进行复杂髋臼重建时，保护SGNB具有挑战性。这些笼子的侧翼设计用于放置在髋臼边缘上方的髂骨上并接受螺钉固定。应用此类笼子可能会因强力牵拉或卡压而导致医源性SGNB损伤。我们描述了一种技术，该技术涉及暴露和松解SGNB，以便能够安全地应用笼子结构的侧翼。
