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[Fascia canals of the greater sciatic foramen and their practical importance]
Abstract:
Fasciae and fat tissue spaces in the gluteal region, topography of the suprapiriform and infrapiriform foramina have been studied by means of a complex anatomical experimental technique. The suprapiriform foramen should be considered as a fascialosseous canal, as it is 4-4.5 cm long and 0.6-1.0 cm wide. It is formed by the upper margin of the greater sciatic notch covered with a thin fascia, fasciae of the gluteal and piriform muscles and the parietal layer of the pelvic fascia. The proper fascial vaginae of the upper gluteal vessels and nerves are adhered to fascial walls of the canal. This peculiarity is used for the method of ligation of the superior gluteal artery within the limits of the suprapiriform canal. The infrapiriform foramen is either narrow or wide enough (up to 2.0 cm in diameter). Inferior gluteal vessels at the level of the sacrospinous ligament go from the parietal layer of the pelvic fascia into the duplicature of the deeper layer of musculus gluteus maximus. The inferior gluteal nerve, above the lower margin of the piriform muscle, ajoining the vessels gets into the fissure of the parietal layer of the pelvic fascia, under the lower margin neurovascular fasciculus also goes through the fissure of the pelvic fascial parietal layer, downward and parallel to the inferior gluteal vessels. The knowledge of possible ways of connections through the canals of the greater sciatic foramen, fat tissue spaces at the subperitoneal level of the small pelvis and the gluteal region is of great practical value.