Hapa Onur, Demirkıran Nihat Demirhan, Hüsemoğlu Buğra, Edizer Mete, Havitçioğlu Hasan
Department of Orthopedics, Dokuz Eylul University Hospital, Izmir, Turkey.
Department of Orthopedics, Dokuz Eylul University Hospital, Izmir, Turkey.
Acta Orthop Traumatol Turc. 2018 Jan;52(1):54-57. doi: 10.1016/j.aott.2017.11.006. Epub 2017 Dec 7.
The aim of this study was to measure the area of iliopsoas tendon attachment and the distance of sciatic nerve, medial circumflex femoral artery (MCFA) and quadratus muscle to lesser trochanter tip, before and after 5, 10, 15 mm depth excision of lesser trochanter.
A total 15 hips of 8 adult male cadavers were evaluated. Distances between lesser trochanter tip, sciatic nerve, the lower edge of quadratus muscle and MCFA; length and width of quadratus muscle insertion; area of iliopsoas muscle and quadratus muscle insertion was measured before and after sequential 5,10 and 15 mm depth trochanterplasties using 5 mm wide burr parallel to the posterior cortex.
Each incremental 5 mm depth bone removal led to significant decrease of tendon area (p=0.001) at each stage. Mean decreases of iliopsoas tendon attachment area with incremental 5 mm burring were 22%±10 with 5 mm, 50%±13 with 10 mm, and 76% ±13 with 15 mm of burring.
Up to 15 mm lesser trochanter removal did not result in complete detachment of the iliopsoas tendon. Lesser trochanter tip was detected at least 20 mm away from important anatomic structures including quadratus tendon, sciatic nerve, and the medial circumflex femoral artery.
本研究旨在测量小转子5mm、10mm、15mm深度切除前后髂腰肌肌腱附着面积以及坐骨神经、股内侧旋动脉（MCFA）和股方肌至小转子尖的距离。
评估8具成年男性尸体的15个髋关节。使用5mm宽的磨钻平行于后皮质，依次进行5mm、10mm和15mm深度的转子成形术，测量小转子尖、坐骨神经、股方肌下缘与MCFA之间的距离；股方肌附着的长度和宽度；髂腰肌和股方肌附着面积。
每次增加5mm深度的骨质去除，在每个阶段均导致肌腱面积显著减小（p = 0.001）。随着5mm磨钻深度增加，髂腰肌肌腱附着面积的平均减小幅度分别为：5mm磨钻时为22%±10，10mm磨钻时为50%±13，15mm磨钻时为76%±13。
小转子切除达15mm并未导致髂腰肌肌腱完全离断。小转子尖距离包括股方肌腱、坐骨神经和股内侧旋动脉在内的重要解剖结构至少20mm。
