髋关节外展伴髋关节伸展造成最大的闭孔神经移位:一项尸体调查。

IF 1.9 Q2 REHABILITATION
Cameron C Bassett, Kerry K Gilbert, Micah Lierly, Troy L Hooper, Nathan E Burgess, Gary Kearns, Jean-Michel Brismeé
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引用次数: 0

摘要

背景:手术或外伤时可能损伤闭孔神经。理论上,神经动力学测试(NDT)有助于识别闭孔神经损伤,但NDT的最佳髋关节位置尚未得到生物力学的支持。目的:本研究评估了骨盆内闭孔神经的位移和应变,使用了髋关节的三个NDT位置(中性、屈曲和伸展)结合髋关节外展。设计:单向重复测量。方法:连续取样9具尸体,将暴露的骨盆内闭孔神经原位粘接金属标记物。将尸体固定在侧卧的屈膝位置,并在起始位置拍摄骨盆内闭孔神经的透视图像。在三个测试体位中重复图像:髋端外展,髋矢状位为中性、屈曲和伸展。将图像数字化,计算和比较位移和应变值。Alpha值设为0.05,对数据进行分析。结果:髋端外展时闭孔神经离起始位置远端移位,髋矢状位为中性位(平均= 2.76±2.46 mm;P = 0.015)和延伸(平均= 3.31±2.14 mm;P = 0.003),但与屈曲无关。三个测试位置的横向位移和应变值无差异(p = 0.948, p = 0.925, p = 0.359)。结论:闭孔神经NDT采用髋端外展,髋矢状位为中立位或伸直位,明显使神经远端移位,提示这些位置在闭孔神经NDT时可能是最有用的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hip abduction with hip extension produces the largest obturator nerve displacement: a cadaveric investigation.

Background: The obturator nerve may be injured during surgery or trauma. Neurodynamic testing (NDT) is theorized to assist in obturator nerve injury identification, but the optimum hip position for NDT has not been biomechanically supported.

Objectives: This study evaluated the displacement and strain of the obturator nerve within the pelvis using three NDT positions of the hip (neutral, flexion, and extension) combined with hip abduction.

Design: One-way repeated measures.

Methods: Nine cadavers were selected by consecutive sampling, and metal markers were glued to the exposed intrapelvic obturator nerves in situ. Cadavers were secured in a side-lying slumped knee bend position, and fluoroscopic images of the intrapelvic obturator nerve were taken in a starting position. Images were repeated during three testing positions: end-range hip abduction with sagittal hip positions in neutral, flexion, and extension. Images were digitized, and displacement and strain values were calculated and compared. Alpha was set at 0.05, and data were analyzed.

Results: The obturator nerve displaced distally from the starting position during end-range hip abduction with the sagittal hip position in neutral (mean = 2.76 ± 2.46 mm; p = 0.015) and extension (mean = 3.31 ± 2.14 mm; p = 0.003) but not with flexion. No lateral displacement or strain value differences were measured between the three testing positions (p = 0.948, p = 0.925, p = 0.359).

Conclusion: Obturator nerve NDT using end-range hip abduction with the sagittal hip position in neutral or extension significantly displaces the nerve distally, suggesting these positions may be most useful when performing NDT of the obturator nerve.

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来源期刊
CiteScore
2.50
自引率
20.00%
发文量
55
期刊介绍: The Journal of Manual & Manipulative Therapy is an international peer-reviewed journal dedicated to the publication of original research, case reports, and reviews of the literature that contribute to the advancement of knowledge in the field of manual therapy, clinical research, therapeutic practice, and academic training. In addition, each issue features an editorial written by the editor or a guest editor, media reviews, thesis reviews, and abstracts of current literature. Areas of interest include: •Thrust and non-thrust manipulation •Neurodynamic assessment and treatment •Diagnostic accuracy and classification •Manual therapy-related interventions •Clinical decision-making processes •Understanding clinimetrics for the clinician
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