| Objective: The buttock of corpses were dissected afterwards to observe layer by layer. The gluteal deep nerves' outer diameter ,depth of drilling through piriformis and adjacent structures were observed. In addition,simple and practical surface anatomical projection were designed. According to the obsevation , the reasonable close operation's operative approach of treating gluteal deep nerves entrapment syndrome with knife-needle were established .In order to expand special needle operation's range of treating chronic soft tissue damage, reducing blindness, preventing the unnecessary operation from damage, and improving clinical effect further.Methods: 15 male adult corpses who were regularly riveted by 10% formalin were selected 。 Left and right sides amounted to 30 sides.The appearance had no obvious limb deformity. The buttock of corpses were dissected from the superficial to the deep by the anatomic instrument, separating the nerves, blood vessels of drilling through the piriformis' upper and lower hole. Observing the following content:①The gluteal deep nerves were dissected afterwards to observe (including the nerves' location adjacent stucture natural branch). ②Measuring the width , thickness of piriformis drilling through pelvic and the distance from it to great trochanter tine; The depth of piriformis' upper and lower edge through pelvic to the surface. ③Measuring the length of thorn corners' line.(the line between posterior superior iliac spine and sacral cornu).The intersection of piriformis upper lower edge extensive line and the thorn corner's line,which were to posterior superior iliac spine. The nip angle of piriformis and posterior midline was measured.④Measuring the outer diameter of the buttock deep nerves, superior gluteal atery, inferior gluteal atery and internal pudendal artery drilling through the piriformis upper and lower hole and the distance from them to thorn comer line severally. ⑤The gluteal deep nerves and blood vessels weretook pictures,kept in thearchives.Results:(l)The width of piriformis drilling through pelvic was 33.03 ± 3.06mm,the thickness was 13.68±3.57mm. The distance between piriformis drilling through pelvic and great trochanter tine was 87.69±4.45mm. The depth of the piriformis upper lower edge through pelvic to the surface were 26.06 ± 5.76mm,27.46 ± 6.01mm respectively.(2)The length of thorn comer line(the line between posterior superior iliac spine and sacral cornu)was 82.06 ±13.69mm. The distance from the intersection of piriformis upper , lower edge to posterior superior iliac spine was 25.26±6.97mm,42.95 ± 12.46mm severally. The nid angle of the piriformis' long axes line and posterior midline was 68.83° ±5.39° . (3)The tranverse diameter of superior gluteal nerve through piriformis' uper hole was 3.98 ± 1.08mm, vertical diameter was 1.38±0.42mm. the distance from it to thorn corner line was 47.07±6.83mm.its branch was 1-3. The tranverse diameter of sciatic nerve through piriformis lower hole was 15.01 ± 3.56mm, vertical diameter was 4.69±1.75mm. the distance from it to thorn corner line was 53.12 ±7.72mm. The tranverse diameter of inferior gluteal nerve through piriformis' lower hole was 5.29±0.71mm, vertical diameter was 2.52± 1.01mm. the distance from it to thorn corner line was 43.57 ± 10.43mm. The tranverse diameter of posterior femoral cutaneous nerve through piriformis'lower hole was 4.59±1.98mm,the vertical diameter wasl.22 ±0.50mm the distance from it to thorn comer line was 41.51 ± 6.95mm. The tranverse diameter of pudendal nerve through piriformis' lower hole was 4.50± 1.20mm,the vertical diameter was 2.11 ±1.11mm, the distance from it to thorn corner line was 37.27±5.99mm. The diameter of superior gluteal artery through piriformis upper hole was 5.44± 1.68mm, the distance from it to thorn corner line was 43.17±7.73mm. The diameter of infeior gluteal artery through piriformis upper hole was 5.29±0.71mm, the distance from it to thorn corner line was 43.57± 10.43mm. The diameter of internal pudendal artery through piriformis' upper hole was 3.46± 1.13mm, the distance from it to thorn corner line was 38.56± 5.92mm.Conclusion :The rational operative procedure with knife-needle for the treatment of the buttock deep nerve entrapment syndrome was mapped out according to the anatomical observation and the adjacent nerves blood vessels that should be protected during the procedure were also pointed out;In addition, Simple and practical exterior anatomical orientation method could provide beneficial reference for medical diagnosis and treatment ofclinical knife-needle operation, clinical acupuncture and massage. The patients of the buttock deep nerve entrapment syndrome was validately treated using the operative approach that the subject designed,and made more satisfactory curative effect. |
PDF Full Text Request