Muresan Claude, Davis Jared M, Hiller Andrea R, Patterson Brittany E, Kapsalis Christina N, Ford Meghan F, Anderson Eric W, Kachare Swapnil D, Hazani Ron, Wilhelmi Bradon J
Division of Plastic Surgery, General Surgery Department, University of Louisville, Louisville, Ky.
University of Louisville School of Medicine, Louisville, Ky. Dr Hazani is in private practice, Beverly Hills, Calif.
Eplasty. 2019 Mar 19;19:e8. eCollection 2019.
The increase in demand for gluteal fat grafting seen in recent years in the United States has not been met with an equal gain in knowledge of the perils of this anatomic territory. The purpose of this study was to identify anatomic landmarks that can be readily used by surgeons to identify the takeoff of the superior and inferior gluteal veins. Six fresh cadaveric gluteal specimens were dissected at the University of Louisville anatomy laboratory. A question mark incision was made for exposure, followed by identification of the sciatic nerve in the proximal thigh. This was traced retrograde to the sciatic forearm. The piriformis muscle was identified dividing the foreman into superior and inferior portions, which corresponded to the takeoff of the superior and inferior gluteal vessels, respectively. The distance of the gluteal vessels from the one-third point of a line from the mid-sacrum to the greater trochanter was measured. Our cadaveric dissection series demonstrated that the superior and inferior gluteal veins were on average 3.28 cm (2-5.9 cm) and 1.25 cm (0-3.5 cm) away from the point one third the distance from the mid-sacral border to the greater trochanter. The mid-sacrum and the trochanter of the femur are the anatomic landmarks used to identify the large gluteal vein trunks. Understanding the location and trajectory of these deep gluteal structures with use of readily identifiable landmarks may assist surgeons in avoiding inadvertent injection of fat to these veins during fat grafting.
近年来，美国对臀脂肪移植的需求不断增加，但人们对该解剖区域风险的了解却没有相应增加。本研究的目的是确定外科医生可以轻易用来识别臀上静脉和臀下静脉起始点的解剖标志。在路易斯维尔大学解剖实验室对六个新鲜尸体臀标本进行了解剖。做了一个问号切口用于暴露，然后在大腿近端识别坐骨神经。沿逆行方向追踪至坐骨支。识别出梨状肌将坐骨小孔分为上、下部分，分别对应臀上血管和臀下血管的起始点。测量了臀血管与从中骶骨到股骨大转子连线三分之一点的距离。我们的尸体解剖系列表明，臀上静脉和臀下静脉平均分别距离中骶骨边界到股骨大转子距离的三分之一点3.28厘米（2 - 5.9厘米）和1.25厘米（0 - 3.5厘米）。中骶骨和股骨大转子是用于识别大臀静脉干的解剖标志。利用易于识别的标志了解这些臀深部结构的位置和走行，可能有助于外科医生在脂肪移植过程中避免无意中将脂肪注入这些静脉。
