From the Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI.
J Am Acad Orthop Surg Glob Res Rev. 2023 Jun 14;7(6). doi: 10.5435/JAAOSGlobal-D-23-00070. eCollection 2023 Jun 1.
This study proposes to establish in-depth inspection of the anatomic structures involved with the pathology of athletic pubalgia in a cadaver model.
Eight male fresh frozen cadavers were dissected in a layered fashion. The rectus abdominis (RA) and adductor longus (AL) tendon insertions were isolated to quantify the size of the anatomic footprint and distance from the surrounding anatomy.
The RA insertional footprint was 1.65 cm (SD, 0.18) in width by 1.02 cm (SD, 0.26) in length, and the AL insertional footprint on the underside of the pubis was 1.95 cm (SD, 0.28) in length by 1.23 cm (SD, 0.33) in width. The ilioinguinal nerve was 2.49 cm (SD, 0.36) lateral to the center of the RA footprint and 2.01 cm (SD, 0.37) lateral to the center of the AL footprint. The spermatic cord and the genitofemoral nerve were just lateral to the ilioinguinal nerve and were 2.76 cm (SD, 0.44) and 2.66 cm (SD, 0.46) from the rectus and AL footprints, respectively.
Surgeons should be cognizant of these anatomic relations during both initial dissection and tendon repair to optimize repair and avoid iatrogenic injury to critical structures in the anterior pelvis.
本研究拟在尸体模型中对与运动性耻骨联合炎相关的解剖结构进行深入检查。
对 8 具男性新鲜冷冻尸体进行分层解剖。孤立腹直肌(RA)和内收长肌(AL)肌腱附着处,以量化解剖足迹的大小和与周围解剖结构的距离。
RA 附着处的足迹宽度为 1.65cm(标准差,0.18),长度为 1.02cm(标准差,0.26);耻骨下 AL 附着处的足迹长度为 1.95cm(标准差,0.28),宽度为 1.23cm(标准差,0.33)。髂腹股沟神经位于 RA 附着处中心外侧 2.49cm(标准差,0.36),AL 附着处中心外侧 2.01cm(标准差,0.37)。精索和生殖股神经刚好位于髂腹股沟神经外侧,距 RA 和 AL 附着处分别为 2.76cm(标准差,0.44)和 2.66cm(标准差,0.46)。
外科医生在初次解剖和肌腱修复时应注意这些解剖关系,以优化修复,并避免在骨盆前区造成医源性损伤。