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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 7, 971-976.
doi: 10.1302/0301-620X.89B7.19053  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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The internervous safe zone for incision of the capsule of the hip

A CADAVER STUDY

R. J. Kampa, MRCS, MBChB, BSc Hons (Anatomical Sciences), Orthopaedic Registrar1; A. Prasthofer, MRCS, MBBS, Orthopaedic Registrar2; D. J. Lawrence-Watt, BSc, PhD, Professor of Human Anatomy3; and R. M. Pattison, FRCS(Trauma & Orth), Consultant Orthopaedic Surgeon4

1 Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 7XX, UK.
2 University Hospital Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK.
3 Brighton and Sussex Medical School, University of Sussex Campus, Falmer, Brighton BN1 9PX, UK.
4 Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK.

Correspondence should be sent to Miss R. J. Kampa at Top Floor Flat, 49 Trent Road, Brixton Hill, London SW2 5BJ, UK; e-mail: bexkampa{at}doctors.org.uk

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° 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.






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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General