Classification and localization of the adductor hiatus: a cadaver study - PubMed
Classification and localization of the adductor hiatus: a cadaver study
Ayşin Kale et al. Balkan Med J. 2012 Dec.
Abstract
Objective: To determine not only the vertical but also horizontal localization of the adductor hiatus (AH) and classify its shape and structure macroscopically.
Material and methods: Forty lower extremities were dissected to expose the AH. Its shape and structure were macroscopically noted, and the AH was classified into four types. For determining the localization, measurements were made with digital calipers.
Results: Twenty-four oval fibrous types, 12 oval muscular types, 2 bridging fibrous types and 2 bridging muscular types of AH were determined. For the horizontal localization of AH, the apex of the AH was determined to be located medial to the vertical line between the midpoint of the interepicondylar distance and the line which was drawn transversely from the apex of the AH, in all of the cadavers. For the vertical one, the apex of the AH was located in the middle third of the femur length in 14 thighs, and in the remaining 26 ones, the apex of the AH was located in the distal third of the femur length.
Conclusion: Adductor hiatus was classified according to its shape and structure for the first time. Moreover, the localization of the AH was practically defined, in order not to harm the popliteal artery and vein.
Keywords: Adductor hiatus; adductor canal outlet syndrome; adductor magnus muscle; femoropopliteal occlusion.
Figures

The illustration showing the measurements taken related with the localization of the adductor hiatus. A) left thigh from behind, B) inlet showing close up view of the AH and the measurements performed to find the localization of the apex of the AH. fl: femur length (the distance between the highest palpable point of the greater trochanter and the horizontal continuation of the interepicondylar distance), hah: height of the adductor hiatus, diam: distance between the apex and the vertical line beginning from the midpoint of the interepicondylar line

Oval fibrous type adductor hiatus. a: apex of the adductor hiatus, cr: cranial, ca:caudal, med: medial, lat: lateral, pa: popliteal artery, pv: popliteal vein

Oval muscular type adductor hiatus. a: apex of the adductor hiatus, cr: cranial, ca:caudal, med:medial, lat:lateral, pa: popliteal artery, pv: popliteal vein, prfa: perforating artery

Bridging fibrous type adductor hiatus. a: apex of the adductor hiatus, cr: cranial, ca:caudal, med: medial, lat: lateral, pa: popliteal artery, pv: popliteal vein

Bridging muscular type adductor hiatus. a: apex of the adductor hiatus, cr: cranial, ca: caudal, med: medial, lat: lateral, pa: popliteal artery, pv: popliteal vein
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References
-
- Moore KL, Dalley AF. Clinically oriented Anatomy. 4th edition. Lippincott Williams & Wilkins; 1999. p. 541.
-
- Standring S, editor. Gray’s Anatomy. 39th edition. Spain: Churchill Livingstone; 2005. p. 1466.
-
- McMillan DE. Blood flow and the localization of atherosclerotic plaques. Stroke. 1985;16:582–7. [CrossRef] - PubMed
-
- Lindblom A. Arteriosclerosis and arterial thrombosis in the lower limb. Acta Radiol. 1950;80:1–80. - PubMed
-
- Scholten FG, Mali WP, Hilen B, van Leeuwen MS. US location of the adductor canal hiatus: a morphologic study. Radiology. 1989;172:75–8. - PubMed
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