An incision of approximately 7-10 cm in length is made across the gluteal region overlying the sacrotuberous ligament.
In some patients, the pudendal nerve may actually be attached to the anterior surface of the sacrotuberous ligament.
In our practice, we most often find the nerve entrapped between the sacrospinous and sacrotuberous ligaments, which form a sort of "V" in the pelvis.
Keywords: sacrotuberous ligament, gluteus maximus, hamstring muscles
This theory is based on an observed partial attachment of the long head of the biceps femoris muscle to the sacrotuberous ligament, which bridges the sacroiliac joint.
A review of anatomical texts revealed that many other muscles and ligaments are also associated with the sacrotuberous ligament, implying that the long head of biceps femoris does not necessarily act in isolation.
5 mm in any plane; a posterior fracture gap; or avulsion of the fifth lumbar transverse process, the lateral border of the sacrum (implying a tear in the sacrotuberous ligament), or the ischial spine (implying a tear in the sacrospinous ligament).
The stability of the pelvic ring is determined by the integrity of the posterior weightbearing sacroiliac complex, which includes the sacroiliac (posterior and anterior), sacrospinous, and sacrotuberous ligaments.
5 cm) or anterior SI joint; stretched but intact SI, sacrotuberous, and sacrospinous ligaments; intact posterior SI ligaments II Symphyseal diastasis greater than 2.
Due to its proximal attachment on to the sacrotuberous ligament, gluteus maximus is thought to cause tightening of the ligament, giving dynamic joint stability and thereby reducing mobility (Vleeming et al.
Vleeming A, Van Wingerden JP, Snijders CJ, Stoeckart R and Stijnen T (1989): Load application to the sacrotuberous ligament; influences on sacroiliac joint mechanics.
Posteriorly the ischiorectal fossae extends below the lower edge of gluteus maximus as far as the sacrotuberous
ligament (Figure 4).