The internervous safe zone for incision of the capsule of the hip. A cadaver study.
In order to determine the potential for an internervous safe zone, 20 hips from human cadavers were dissected to map out the precise pattern of innervation of the hip capsule. The results were illustrated in the form of a clock face. The reference point for measurement was the inferior acetabular notch, representing six o'clock. Capsular branches from between five and seven nerves contributed to each hip joint, and were found to innervate the capsule in a relatively constant pattern. An internervous safe zone was identified anterosuperiorly in an arc of 45 degrees between the positions of one o'clock and half past two. Our study shows that there is an internervous zone that could be safely used in a capsule-retaining anterior, anterolateral or lateral approach to the hip, or during portal placement in hip arthroscopy.
Royal Sussex County Hospital, Brighton, UK. bexkampa@doctors.org.uk
R J
RJ
Kampa
A
A
Prasthofer
D J
DJ
Lawrence-Watt
R M
RM
Pattison
D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods*; D002102:Cadaver; D005260:Female; D006621:Hip Joint / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D017746:Joint Capsule / Q000033:anatomy & histology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020196:Trauma, Nervous System / Q000517:prevention & control*