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T Sato - One of the best experts on this subject based on the ideXlab platform.
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origin course and distribution of the Superior Gluteal Nerve
Cells Tissues Organs, 1994Co-Authors: Keiichi Akita, H Sakamoto, T SatoAbstract:Ten pelvic halves of six Japanese male cadavers were dissected in order to obtain precise anatomical knowledge of the course and distribution of the Superior Gluteal Nerve. The more anterior parts of
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the cutaneous branches of the Superior Gluteal Nerve with special reference to the Nerve to tensor fascia lata
Journal of Anatomy, 1992Co-Authors: Keiichi Akita, H Sakamoto, T SatoAbstract:Cutaneous branches from the Superior Gluteal Nerve were studied in 39 half pelves (18 right, 21 left) of 23 adult Japanese cadavers. A detailed description of the branches is not currently available in the literature. Most of these branches perforated tensor fascia lata and were distributed to the centre of the lateral Gluteal region.
Keiichi Akita - One of the best experts on this subject based on the ideXlab platform.
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a case in which a branch from the Superior Gluteal Nerve innervated the rectus femoris and the vastus lateralis
Annals of Anatomy-anatomischer Anzeiger, 1994Co-Authors: Keiichi Akita, Hirokazu Sakamoto, Tatsuo SatoAbstract:During dissection of the Gluteal region, a branch from the most cranial root of the Superior Gluteal Nerve was found to innervate the rectus femoris and the vastus lateralis on the right side of a 41-year-old Japanese male cadaver. This case is an example of Eisler's so-called "competition for innervation areas" (Eisler 1895).
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origin course and distribution of the Superior Gluteal Nerve
Cells Tissues Organs, 1994Co-Authors: Keiichi Akita, H Sakamoto, T SatoAbstract:Ten pelvic halves of six Japanese male cadavers were dissected in order to obtain precise anatomical knowledge of the course and distribution of the Superior Gluteal Nerve. The more anterior parts of
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the cutaneous branches of the Superior Gluteal Nerve with special reference to the Nerve to tensor fascia lata
Journal of Anatomy, 1992Co-Authors: Keiichi Akita, H Sakamoto, T SatoAbstract:Cutaneous branches from the Superior Gluteal Nerve were studied in 39 half pelves (18 right, 21 left) of 23 adult Japanese cadavers. A detailed description of the branches is not currently available in the literature. Most of these branches perforated tensor fascia lata and were distributed to the centre of the lateral Gluteal region.
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Stratificational relationship among the main Nerves from the dorsal division of the sacral plexus and the innervation of the piriformis
The Anatomical record, 1992Co-Authors: Keiichi Akita, Hirokazu Sakamoto, Tatsuo SatoAbstract:In order to comprehend more completely the morphology of the Nerves to the piriformis, it is necessary to obtain a detailed understanding of the relationship of the origin and the course of these Nerves from the dorsal division of the sacral plexus, with reference to the Superior and inferior Gluteal Nerves. Twelve of seven human pelvic halves were carefully dissected in order to examine the origins of the Nerves from the dorsal division of the sacral plexus. Six of these pelvic halves were further dissected under a stereomicroscope to examine the Nerves to the piriformis. 1 The origin of the Superior Gluteal Nerve was more proximal and dorsal in the sacral plexus than that of the inferior Gluteal Nerve. 2 The Superior Gluteal Nerve consisted of a thick cranial part and a thin caudal part; the former continued as the inferior branch of the Nerve, and the latter, the Superior branch. The cranial and caudal parts crossed before reaching the glutei medius and minimus. 3 The Nerves to the piriformis arose from three main Nerves from the dorsal division of the sacral plexus: (1) the caudalmost root of the Superior Gluteal Nerve, (2) the caudal roots of the inferior Gluteal Nerve and (3) the common peroneal Nerve. Considering the stratificational relationship among the main Nerves from the dorsal division of the sacral plexus, the piriformis appears to be composed of parts from different muscle layers. © 1992 Wiley-Liss, Inc.
Atsushi Okawa - One of the best experts on this subject based on the ideXlab platform.
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Incidence of tensor fascia lata muscle atrophy after using the modified Watson-Jones anterolateral approach in total hip arthroplasty
European Journal of Orthopaedic Surgery & Traumatology, 2020Co-Authors: Ryohei Takada, Tetsuya Jinno, Kazumasa Miyatake, Masanobu Hirao, Toshitaka Yoshii, Atsushi OkawaAbstract:Background Post-operative tensor fascia lata (TFL) muscle atrophy due to Superior Gluteal Nerve (SGN) injury during total hip arthroplasty (THA) can affect patients’ post-operative hip function. This study aimed to determine the incidence of TFL muscle atrophy in THA performed via the modified Watson-Jones anterolateral approach and the risk factors for TFL atrophy. Methods We reviewed pre- and post-operative magnetic resonance imaging (MRI) data of 164 patients who underwent cementless THA via the modified Watson-Jones approach at one institution. TFL atrophy was defined as worsening of ≥ 2 grades in the Goutallier classification or > 40% decrease in the cross-sectional area (CSA) of the TFL on post-operative MRI compared to that on preoperative MRI. Patients’ backgrounds were compared between those with or without TFL atrophy to determine the risk factors of TFL atrophy. Fatty atrophy grade and CSA of the gluteus minimus and medius were also evaluated. Results Thirteen (8.0%) cases of TFL atrophy were detected. The mean body mass index (BMI) in the cases with TFL atrophy was significantly higher than in those without TFL atrophy ( p = 0.012). The fatty atrophy grade was worse post-operatively than preoperatively; moreover, the CSA of the gluteus minimus decreased. Conclusions We found a low incidence of TFL atrophy due to SGN injury after THA using the modified Watson-Jones approach. High BMI can be a risk factor for Nerve injury. The gluteus minimus can be injured directly during surgery. We suggest that overexposure of the surgical site should be avoided, especially in patients with high BMI.
D Knowles - One of the best experts on this subject based on the ideXlab platform.
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the anatomical relations of the Superior Gluteal Nerve and damage to it during the direct lateral approach to the hip a cadaveric study
Orthopaedic Proceedings, 2008Co-Authors: D Knowles, T KhanAbstract:We examined the position of the Superior Gluteal Nerve in forty-four cadaveric hips in relation to the greater trochanter and the acetabulum . We found that the Nerve lay a mean of 4.8 centimetres from the greater trochanter with a range of two to nine centimetres and a mean of 3.2 centimetres from the acetabulum. The Nerve was visibly damaged in three out of forty-four hips following direct lateral approach. Our study does not support the “safe zone” proximal to the greater trochanter and suggests the proximity of the Nerve to the acetabulum as a potential cause of Nerve injury. Abductor weakness following the direct lateral approach to the hip is well described and is associated with damage to the Superior Gluteal Nerve on neurophysiological testing in from 23–26 %. A “safe zone” has been described of up to five centimeters proximal to the greater trochanter. We examined forty-four cadaveric hips exposed by the direct lateral approach by surgeons not directly involved with the study. We measured the position of the Superior Gluteal Nerve in relation to the greater trochanter, the acetabulum and the margin of the skin incision. We examined the Nerve for visible signs of damage. We found the position of the Superior Gluteal Nerve to be a mean of 4.8 centimeters from the greater trochanter (range two to nine), 3.2 centimeters from the Superior margin of the acetabulum (range one to eight), and 4.1 centimeters from the margin of the skin incision. There was visible damage to the Nerve in three of forty-four cases. Neurophysiological studies show subclinical damage to the Superior Gluteal Nerve in up to 77% of cases following direct lateral approach to the hip and in association with abductor weakness in 23–26%. Our study does not support the notion of a “safe zone” of five centimetres proximal to the greater trochanter, and with a mean of 4.8 centimetres the zone is unsafe more often than it is safe. The proximity of the Superior Gluteal Nerve to the Superior margin of the acetabulum suggests that it may be damaged by retractor placement at this site.
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damage to the Superior Gluteal Nerve during the direct lateral approach to the hip a cadaveric study
Journal of Arthroplasty, 2007Co-Authors: T Khan, D KnowlesAbstract:The direct lateral approach to the hip is one of the most commonly used surgical approaches for hip arthroplasty. The inferior division of the Superior Gluteal Nerve (SGN) is the main Nerve supply to the abductor muscles of the hip and may be damaged during this approach. The exact incidence of permanent damage to the SGN is not known. The present study is based on cadaveric dissection of the SGN after a surgical approach to the hip joint for hip arthroplasty. The inferior division of the SGN was found to be damaged in 3 (6.8%) of 44 cases. We conclude that a true "safe zone" does not exist when using a direct lateral approach. We also found out that the incidence of physical damage to the SGN is rare and depends largely on the branching pattern of the Nerve.
Ch Van Der Werke - One of the best experts on this subject based on the ideXlab platform.
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soft tissue injury related to choice of entry point in antegrade femoral nailing piriform fossa or greater trochanter tip
Injury-international Journal of The Care of The Injured, 2005Co-Authors: C Ansari M Moei, Michiel Verhofstad, R L A W Leys, Ch Van Der WerkeAbstract:Intramedullary nailing through the piriform fossa results in some cases in loss of abduction strength and persistent pain. Nail insertion at the tip of the greater trochanter may be favourable. The aim of this study was to assess (possible) iatrogenic injury to the abductor and external rotator musculature, branches of the Superior Gluteal Nerve and branches of the MFCA in relation to the two different entry points. In 10 fresh human cadaver femurs, five unreamed femoral nails (UFN) were inserted through the piriform fossa and five AO prototype nails (AFN) through the trochanteric tip. The iatrogenic injury at each nailing procedure was assessed. Various muscles and tendons, branches of the MFCA along with the hip joint capsule were injured or largely at risk during nail insertion through the piriform fossa. Most of these structures were not exposed during insertion through the trochanteric tip. The reported clinical morbidity after nailing through the piriform fossa may find its origin in direct soft tissue injury and may be reduced by choosing a lateral nail entry point.
