Department of Orthopaedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany; Department of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Department of Anatomy, Tokyo Medical University, Tokyo, Japan.
Ann Anat. 2021 Jul;236:151698. doi: 10.1016/j.aanat.2021.151698. Epub 2021 Feb 11.
Conflicting anatomical reports and the little attention given to the pubic ligaments impede the interpretation of radiological and clinical examinations on groin pain. Morphometric data on the pubic ligaments are lacking.
The muscular relations of the symphysis pubis were examined in layered dissection (n = 10), hemipelves (n = 60) and (un)stained plastinated body slices of body donors (n = 3). The sagittal and coronal areas, width, mean and maximum thickness of pubic ligaments were determined.
The adductor longus, brevis, rectus abdominis and pyramidalis muscles are attached to the anterior pubic ligament (APL). The adductor brevis and gracilis muscle are connected to the inferior pubic ligament (IPL). The IPL and superior pubic ligament (SPL) are thicker than the APL and posterior pubic ligament (PPL). The PPL is the thinnest pubic ligament. The APL has a larger sagittal area in women than in men compared to the IPL. The SPL and IPL are thicker in men compared to women.
The APL is the ligamentous anchor for the originating and inserting muscles. Investigations of the pubic ligaments might help to determine symphysis instability or severity of injury and should be included as a further criterion for surgical management.
解剖学报告存在矛盾，且耻骨联合韧带上的关注较少，这阻碍了对腹股沟疼痛的放射学和临床检查的解读。耻骨联合韧带上的形态计量数据也较为缺乏。
我们在分层解剖（n = 10）、半骨盆（n = 60）和尸体捐献者的未染色塑化体切片（n = 3）中检查了耻骨联合的肌肉关系。确定了耻骨联合韧带的矢状面和冠状面区域、宽度、平均和最大厚度。
长收肌、短收肌、腹直肌和耻骨肌附着于前耻骨联合韧带（APL）。短收肌和长收肌连接到下耻骨联合韧带（IPL）。IPL 和上耻骨联合韧带（SPL）比 APL 和后耻骨联合韧带（PPL）厚。PPL 是最薄的耻骨联合韧带。与 IPL 相比，女性 APL 的矢状面区域大于男性。与女性相比，男性的 SPL 和 IPL 更厚。
APL 是起始和插入肌肉的韧带附着点。对耻骨联合韧带上的研究可能有助于确定耻骨联合的不稳定性或损伤的严重程度，并且应该作为手术治疗的进一步标准。
