Department of ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Physical and Rehabilitative Medicine, Antwerp University Hospital, Edegem, Belgium.
Department of ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Orthopaedic Surgery and Traumatology, Antwerp University Hospital, Edegem, Belgium.
Ann Anat. 2024 Jun;254:152238. doi: 10.1016/j.aanat.2024.152238. Epub 2024 Feb 24.
Pubis-related groin pain remains a difficult topic in orthopedic and sports medicine. A better understanding of the anatomy of the adductors and the pubic ligaments is necessary. The aim of this study is to map all the musculotendinous attachments to the pubic ligaments and to investigate in detail all the possible inter-adductor fusions.
The pubic symphyses were dissected in eight male and fourteen female embalmed cadavers (mean age 85 years), focusing on the fusion between the adductors, pubic ligaments, and musculotendinous attachments at the pubic ligaments. The 95% confidence intervals for the prevalence of the different conjoint tendons and tendon attachment to ligament were calculated.
The presence of three types of conjoint tendons was found: adductor brevis and gracilis (AB/G) 90.9 [72.2 - 97.5]%; adductor brevis and adductor longus (AB/AL) 50.0 [30.7 - 69.3]%; adductor longus and gracilis (AL/G) 50.0 [30.7 - 69.3]%. The AL, AB and G were in every cadaver attached to the anterior pubic ligament (APL). 64% of the AB and 100% of the G were attached to the inferior pubic ligament (IPL).
The proximal anatomy of the adductors is more complex than initially described. This study identified three possible conjoint tendons between the proximal adductors. The AB/G conjoint tendon was significantly more present than the AB/AL or AL/G conjoint tendon. The IPL has attachments only from the AB and G. Rectus Abdominis (RA) and AL were not attached to IPL. Mapping the musculotendinous attachments on the pubic ligaments creates more clarity on the pathophysiology of lesions in this area.
耻骨相关腹股沟疼痛仍然是骨科和运动医学中的一个难题。需要更好地了解内收肌和耻骨韧带的解剖结构。本研究的目的是绘制所有耻骨韧带的肌-腱附着点，并详细研究所有可能的内收肌融合。
在 8 名男性和 14 名女性防腐尸体（平均年龄 85 岁）中解剖耻骨联合，重点关注内收肌、耻骨韧带和耻骨韧带的肌-腱附着点之间的融合。计算不同联合肌腱和腱附着于韧带的 95%置信区间的患病率。
发现存在三种类型的联合肌腱：短内收肌和长内收肌（AB/G）90.9%[72.2%-97.5%]；短内收肌和短内收肌（AB/AL）50.0%[30.7%-69.3%]；长内收肌和长内收肌（AL/G）50.0%[30.7%-69.3%]。在每个尸体中，AL、AB 和 G 都附着于前耻骨韧带（APL）。64%的 AB 和 100%的 G 附着于耻骨下韧带（IPL）。
内收肌的近端解剖结构比最初描述的更复杂。本研究确定了近端内收肌之间的三种可能的联合肌腱。AB/G 联合肌腱的存在明显多于 AB/AL 或 AL/G 联合肌腱。IPL 仅附着于 AB 和 G。腹直肌（RA）和 AL 不附着于 IPL。绘制耻骨韧带的肌-腱附着点可以更清楚地了解该区域病变的病理生理学。
