Bos J C, Stoeckart R, Klooswijk A I, van Linge B, Bahadoer R
Department of Orthopedics, Antonius Ziekenhuis, Sneek, The Netherlands.
Surg Radiol Anat. 1994;16(3):253-8. doi: 10.1007/BF01627679.
In view of the increasing popularity of the direct lateral approach to the hip joint for hemi- or total hip arthroplasty, the location of the superior gluteal nerve (SGN) was studied. This nerve is in danger when using a transgluteal incision. In 20 embalmed specimens the relation of the SGN to the tip of the greater trochanter (TT) was studied as well as the relation to the iliac crest. For this purpose macroscopy, microscopy and CT were used. In 13 hips a so-called most inferior branch was found at an average of 1 cm distal to the inferior branch, the main trunk of the nerve. There was substantial variation in the course of both the inferior and the most inferior branch of the SGN. In order to prevent nerve damage, proximal extension of the transgluteal incision should be limited to 3 cm cranial to TT. Furthermore the incision has to be confined to the distal one third of the distance TT-iliac crest. In tall people extra care should be taken.
鉴于直接外侧入路在半髋关节或全髋关节置换术中用于髋关节的应用日益广泛，对臀上神经（SGN）的位置进行了研究。使用经臀切口时，该神经存在风险。在20个防腐标本中，研究了SGN与大转子（TT）尖端的关系以及与髂嵴的关系。为此，采用了宏观检查、显微镜检查和CT检查。在13个髋关节中，发现了一条所谓的最下分支，平均位于神经主干下支远端1 cm处。SGN下支和最下支的走行存在很大差异。为防止神经损伤，经臀切口的近端延伸应限制在TT上方3 cm以内。此外，切口必须局限于TT与髂嵴距离的远端三分之一处。对于高个子的人，应格外小心。
