Hip joint chronic pain can severely compromise patients' life quality. Peripheral nerve blocks play an important role as diagnostic and therapeutic procedures. The aim of this work is to study the anatomy of the nerve to quadratus femoris (NQF) in view of the possibility of its percutaneous selective block. Forty-three gluteal cadaveric regions fixed in formaldehyde solution were dissected. The quadratus femoris, the obturator internus and superior and inferior gemellus were freed from their lateral insertion, exposing thus the posterior aspect of the hip joint. The NQF was identified, and the horizontal distance to the posterior edge of the greater trochanter at its upper, middle and lower thirds was registered. The number of the articular branches of the NQF was identified. Likewise, the horizontal distance to the posterior edge of the greater trochanter and the longitudinal distance to the line through the distal end of the posterior edge of the greater trochanter were measured. The distance between the NQF and the greater trochanter posterior edge at upper, middle and lower thirds was 46 mm, 41 mm and 35 mm, respectively. In most cases (85 %) the NQF presented one or two articular branches. The longitudinal distances between the line through the distal end of the posterior edge of the greater trochanter and the origin of the first, second and third articular branches of the NQF were 14.7 mm (-19.4-40), 16.4 mm (-9.3-42) and 27 mm (0-46), respectively. The distances to the posterior edge of the greater trochanter were 43.1 mm (16.3-66), 37.7 mm (6.5-53) and 39.8 mm (26-52), for the first, second and third articular branches, respectively. In conclusion, the articular branches of the nerve to quadratus femoris have a constant and predictable distribution. Our findings allow for generating a coordinate system for the selective block of the NQF by way of percutaneous techniques.
Introducción: la vena porta origina clásicamente de la confluencia de las venas mesentérica superior y tronco espleno mesentérico, conformado por las venas esplénica y mesentérica inferior. Su conformación y principales afluentes no escapa de presentar variaciones anatómicas, las cuales el cirujano debe conocer y anticipar, al momento del abordaje del macizo duodeno pancreático en vistas a evitar consecuencias catastróficas. El objetivo es el estudio de la conformación, dimensiones y disposición espacial de la vena porta en su origen, y sus principales afluentes. Materiales y método: se utilizaron 50 cadáveres formolados. Se registró origen de la vena porta, calibre de la misma y sus afluentes. ángulos de abocamiento y nivel vertebral de proyección. Resultados: se distinguieron tres tipos de origen. Se registró el tipo I en el 78% de los casos, tipo II en el 18% y tipo III en el 4%. Los calibres fueron: vena porta 16,12 mm, mesentérica superior 11,77 mm, esplénica 9,34 mm, mesentérica inferior 5,03 mm y tronco esplenomesaraico de 10,44 mm. Este último, alcanzó una longitud de 20,26 mm. Los ángulos fueron: ángulo porta - tronco esplenomesenterico 124,18°, ángulo mesentérica superior - tronco esplenomesenterico 101,92° y ángulo mesentérica inferior - esplénica 75,4°. En el 75% de los casos el nivel de proyección vertebral fue el tercio superior de L2. Conclusiones: El origen mas frecuente fue el clásicamente descrito. De sus variantes, es mas constante la reunión de la vena mesentérica superior con la vena esplénica, y mas variable la desembocadura de la vena mesentérica inferior.
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