Lezak Bradley, Massel Dustin H.
University of Miami Miller School of Med
Univ. of Miami/Jackson Memorial Hospital
The superior and inferior gemellus muscles are a pair of small triangle-shaped muscles found among the posterior hip and gluteal musculature in the posterior proximal lower extremity, commonly referred to collectively as the gemelli muscles. The gemelli muscles are two of six short external rotator muscles in the gluteal region of the proximal thigh. The remaining external rotators include the piriformis, obturator internus, quadratus femoris, and obturator externus muscles. The superior and inferior gemelli join the obturator internus as a conjoined tendon, sometimes referred to as the triceps coxae. The gemelli muscles assist in external rotation of the thigh and have implications in sciatic nerve dysfunction known as deep gluteal space syndrome or gemelli-obturator syndrome. The gemelli muscles, in conjunction with the obturator internus, are important surgical landmarks in the Kocher-Langenbeck and posterior approach to the hip, as well as essential for identifying and protecting the medial circumflex femoral artery. The surgical approaches described are useful for surgical hip dislocations, total hip arthroplasty, hip hemiarthroplasty, loose body removal, treatment of posterior wall and column acetabular, and pelvic ring fractures.
上孖肌和下孖肌是一对小的三角形肌肉，位于下肢近端后方的臀部和臀肌组织中，通常统称为孖肌。孖肌是大腿近端臀部区域六块短外旋肌中的两块。其余的外旋肌包括梨状肌、闭孔内肌、股方肌和闭孔外肌。上孖肌和下孖肌与闭孔内肌以联合腱相连，有时称为髋部三头肌。孖肌协助大腿进行外旋，并且在称为深部臀间隙综合征或孖肌-闭孔综合征的坐骨神经功能障碍中起作用。孖肌与闭孔内肌一起，是髋部Kocher-Langenbeck入路和后路手术中的重要手术标志，也是识别和保护旋股内侧动脉的关键。所描述的手术入路对于髋关节脱位手术、全髋关节置换术、髋关节半置换术、游离体取出、髋臼后壁和柱骨折以及骨盆环骨折的治疗很有用。
