Surgical and radiologic anatomy : SRA
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The authors present a study of the intrinsic anatomy of the gluteus medius m, and of its innervation through the caudal branch of the superior gluteal n. The existence of an intramuscular tendon in the thickness of the gluteus medius was constantly prooved in 40 muscles. ⋯ The authors deduce from that the topography of a gluteus medius incision, with respect to a safety area towards its innervation, which leads to an exposure of the acetabulum that is satisfying and gives opportunities of a sound repair after the surgery of the hip joint through the transgluteal approach. They propose the "anterior hemimyotomy of the gluteus medius m" designation.
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Typically obturator nerve blockade is used to relieve hip pain. It sometimes only has a minor effect in resolving symptoms. This clinical observation led us to examine comprehensively the sensory nerve innervation of formalin-fixed hip joint capsules. ⋯ This anatomical study demonstrates that the obturator n. block is insufficient for the treatment of hip pain. Further investigations will determine if these nn. can be reached percutaneously. Effective neural blockade of the hip joint must include the femoral n., the sciatic n. and the superior gluteal n.
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Direct measurements and measurements from images of axial cross-sections on 20 cadaveric sacra that had been scanned on computer were used in this study. The measurements, including parameters from the vertebral body, lateral mass and spinal canal of the second sacral vertebra (S2) were performed. The length of the screw path and the optimal angulation of the screw placement for dorsal sacral internal fixation were also included. ⋯ The present study provides quantitative anatomic data of the second sacral vertebra. All parameters indicate that, compared with our previous study, S2 is smaller than S1. When S2 lateral mass screw fixation is intended, anchoring the anterior cortex may violate the iliac vessels or lumbosacral trunk; therefore, understanding the unique anatomy of the S2 is imperative.