尺骨鹰嘴关节外截骨入路的解剖学研究及临床意义  

The anatomy and clinical significance of the approach of extra-articular oblique osteotomy of olecranon

作　　者：刘会仁[1] 刘小坡[2] 刘德群[1] 

机构地区：[1]唐山市第二医院手外科 [2]华北煤炭医学院,河北唐山063000

出　　处：《中国临床解剖学杂志》2009年第1期9-11,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:为尺骨鹰嘴关节外斜行截骨手术入路提供解剖学依据。方法:选用成年上肢防腐标本男女各20侧。观察尺骨鹰嘴解剖形态并测量相关结构参数,侧位X-线片测量并确定截骨角度,综合确定截骨平面,完成截骨和固定试验。结果①尺骨鹰嘴关节侧为半弧形,背侧骨质为接近直角弯曲的鹰嘴突,断面呈尖端向关节的扇形,肱三头肌腱止于鹰嘴尖与鹰嘴突之间的局限区域,男、女性结构形态相同。②测得肱三头肌腱止点长度、止点宽度、肌腱近缘处鹰嘴骨质厚度、肌腱远缘处鹰嘴骨质厚度、鹰嘴尖至肱三头肌腱近缘距离,男女分别为:(21.63±1.59)mm,(18.61±1.62mm);(23.56±1.33)mm,(20.69±1.77)mm;(8.38±0.76)mm,(7.33±0.74)mm;(20.78±1.40)mm,(17.62±1.32)mm;(9.00±0.86)mm,(7.39±0.90)mm;男女尺骨鹰嘴相关结构参数存在性别差异(P<0.05)。③经尺骨鹰嘴肱三头肌腱止点近侧缘与尺骨近端背侧呈(134.82±4.9)°夹角的冠状面为截骨面。④截骨后固定方便牢固。结论:经尺骨鹰嘴关节外斜行截骨手术入路可行,有较好的临床实用价值。Objective： To provide anatomic basis for the approach of extra-articular oblique osteotomy of olecranon. Methods： Forty cadaveric upper limb specimens （20 of male and 20 of femal） were dissected. The plane of osteotomy was decided by anatomic measurement and the data of X-ray of olecranon process, and then the osteotomy and fixation was carried out. Results： （1）The appearance of articular facet of olecranon looked like an arc, with a quarter bend of dorsal aspect, and a fan-shaped lateral section. There were no difference of the shape of olecranon between male and female. （2） The length of triceps brachii insertion was （21.63±1.59） mm and （18.61±1.62） mm in male and female, and the width （23.56±1.33） mm and （20.69±1.77） mm respectively; the olecranon thickness of triceps tendon peri-edge was （8.38±0.76） mm and （7.33±0.74） mm, and the apo-edge （20.78±1.40） mm and （17.62±1.32） mm; the distance fi＇om olecranon spur to triceps brachii insertion was （9.00±0.86） mm, （7.39±0.90） mm respectively. The differences of the data between male and female were significant （P〈0.05）. （3）The plane of safety osteotomy was the coronal plane, which is lateral to the peri-edge of triceps tendon insertion with an angle of （134.82±4.9）° to the dorsal side of olecranon. （4）The fixation was feasible and stable. Conclusions： The approach of extra-articular oblique osteotomy is valuable in clinical application.

关 键 词：应用解剖 肱骨骨折 尺骨鹰嘴 截骨术 手术入路 

分 类 号：R323.71[医药卫生—人体解剖和组织胚胎学]