Iliopsoas tendon insertion footprint with surgical implications in lesser trochanterplasty for treating ischiofemoral impingement: an anatomic study.
Iliopsoas tendon insertion footprint with surgical implications in lesser trochanterplasty for treating ischiofemoral impingement: an anatomic study.
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DOI：
10.1093/jhps/hnv060
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发表时间：
2015-12
影响因子：
1.5
通讯作者：
Martin HD
中科院分区：
文献类型：
--
作者：
Gómez-Hoyos J;Schröder R;Palmer IJ;Reddy M;Khoury A;Martin HD
本研究的目的是描述髂腰肌腱在小转子上的足迹位置，以阐明小转子成形术治疗坐骨股骨撞击的手术意义。包括十个不匹配的新鲜冷冻半骨盆尸体标本（平均年龄，62.4 岁；范围，48-84 岁；7 名男性和 3 名女性）。注册的测量包括小转子的骨参数（小转子面积、坐标系中从尖端到基部的距离、高度和面积）和腱性髂腰肌足迹描述（面积和详细位置）。小转子平均高度为13.1（SD ± 1.8）mm，女性小转子平均较小（11.3，SD±2.0）。在 7 个（70%）样本中发现了双腱足印。单足迹和双足迹的平均面积分别为 211.2 mm2 和 187.9 mm2。所有标本中均存在小转子前部无腱附着的前皮质区域，平均测量为 4.9mm（SD±0.6）。前壁秃头与小转子高度之间的平均比率为38%（SD ± 0.05）。在大多数情况下，髂腰肌腱足迹是双的（腰肌和髂肌），并且位于小转子的前内侧尖端。小转子底部的前壁秃头表明，在不部分或完全分离髂腰肌腱的情况下，进行部分或全部小转子成形术以增加坐骨股骨空间是不可能的。
The objective of this study was to describe the footprint location of the iliopsoas tendon on the lesser trochanter to clarify the surgical implications of the lesser trochanterplasty for treating ischiofemoral impingement. Ten non-matched, fresh-frozen, cadaveric hemipelvis specimens (average age, 62.4 years; range, 48–84 years; 7 male and 3 female) were included. Registered measures included bony parameters of the lesser trochanter (lesser trochanteric area, distances from the tip to the base in a coordinate system, height and area) and tendinous iliopsoas footprint descriptions (areas and detailed location). The mean height of the lesser trochanter was 13.1 (SD ± 1.8) mm, with female having a smaller lesser trochanter on average (11.3, SD ± 2.0). A double tendinous footprint was found in 7 (70%) specimens. The average area of the single- and double-footprint was 211.2 mm2 and 187.9 mm2, respectively. An anterior cortical area with no tendinous insertion on the anterior aspect of lesser trochanter was present in all specimens and measured 4.9 mm (SD ± 0.6) on average. The mean ratio between the bald anterior wall and the lesser trochanter height was 38% (SD ± 0.05). The iliopsoas tendon footprint is double (psoas and iliacus) in most cases and is located on the anteromedial tip of the lesser trochanter. A bald anterior wall on the bottom of the lesser trochanter indicates that a partial or total lesser trochanterplasty for increasing the ischiofemoral space without detaching partially or entirely the iliopsoas tendon is improbable.