Tourvas Evangelos A, Zibis Aristidis H, Klontzas Michail E, Karantanas Apostolos H, Bastian Johannes D, Tosounidis Theodoros H
Department of Orthopaedic Surgery, Medical School, University of Crete, 71110 Heraklion, Greece.
Department of Anatomy, Faculty of Medicine, University of Thessaly, 41334 Larissa, Greece.
SICOT J. 2025;11:4. doi: 10.1051/sicotj/2024053. Epub 2025 Jan 20.
The primary aim of this study is to determine the rectus abdominis tendon (RAT) insertional anatomy and consequently clarify the extension of secure mobilization of the tendon from the pubic bone in the setting of anterior approaches in pelvic and acetabular reconstruction surgery.
Eleven fresh frozen cadaveric pelvises were dissected by two fellowship-trained orthopaedic trauma surgeons utilizing the anterior intrapelvic approach (AIP). The RAT at the pubic body was dissected, and its footprint on the pubic bone was defined, marked, and measured.
Nineteen (19) RAT insertions were analyzed. The average total medial vertical length was 33 mm (range 26-42 mm), and the average total lateral vertical length was 36.5 mm (range 26-46 mm). The total width of the proximal insertion on both sides was measured at an average of 20.42 mm (range 14-24 mm). The average width of the tendon at the transition area between the cranial and caudal areas of the pubic bone was 16.45 mm (range 12-22 mm). The average distal insertion width of the RAT was less than the proximal and middle widths, measuring 10.45 mm (range 8-13 mm).
The tendon can be safely mobilized up to an average total medial vertical length of 33 mm (and in no case more than 42 mm) and to an average total lateral vertical length of 36.5 mm (and in no case more than 46 mm). This piece of anatomical information will equip orthopaedic surgeons with a better understanding of the insertional anatomy of the RAT and subsequent safer surgical release when performing anterior approaches to the pelvic ring.
本研究的主要目的是确定腹直肌腱（RAT）的插入解剖结构，从而明确在骨盆和髋臼重建手术的前路手术中，该肌腱从耻骨安全游离的范围。
由两位接受过专科培训的骨科创伤外科医生采用经骨盆内前路（AIP）对11个新鲜冷冻尸体骨盆进行解剖。解剖耻骨体处的RAT，确定、标记并测量其在耻骨上的附着区域。
分析了19个RAT附着点。内侧垂直总长度平均为33毫米（范围26 - 42毫米），外侧垂直总长度平均为36.5毫米（范围26 - 46毫米）。两侧近端附着处的总宽度平均为20.42毫米（范围14 - 24毫米）。耻骨骨的头侧和尾侧区域之间的过渡区肌腱平均宽度为16.45毫米（范围12 - 22毫米）。RAT的远端附着宽度小于近端和中间宽度，为10.45毫米（范围8 - 13毫米）。
该肌腱可安全游离至内侧垂直总长度平均为33毫米（在任何情况下均不超过42毫米），外侧垂直总长度平均为36.5毫米（在任何情况下均不超过46毫米）。这一解剖学信息将有助于骨科医生在进行骨盆环前路手术时更好地理解RAT的插入解剖结构，并进行更安全的手术松解。
