体外钢板固定治疗锁骨骨折的应用解剖  

External plate fixation for treating the clavicle fracture:an applied anatomic study

作　　者：骆宇春[1] 王诗波[1] 樊嵘[1] 张发惠[2] 高建明[1] 许斌[1] 华国军[1] 

机构地区：[1]解放军第101医院骨科,江苏无锡214044 [2]南京军区福州总医院军区骨科研究所,福州350025

出　　处：《中国临床解剖学杂志》2012年第1期26-28,共3页Chinese Journal of Clinical Anatomy

基　　金：南京军区医学科研重点课题(08Z004)

摘　　要：目的观察锁骨重要毗邻结构的解剖特征及其体表投影,为体外钢板固定治疗锁骨骨折的安全性提供基础。方法成人尸体标本15具30侧,分别观察锁骨下动静脉及臂丛和锁骨以及喙突的毗邻关系,并测量相应数据,确定锁骨下动静脉及臂丛在锁骨表面的投影范围。结果锁骨下动静脉及臂丛在锁骨表面的投影范围大约在其由内向外的第二个1/4段。锁骨下动静脉及臂丛和锁骨下缘的最近距离左侧平均为0.42 cm,右侧平均为0.57 cm。结论体外钢板固定治疗锁骨骨折时在锁骨由内向外的第二个1/4段穿针时要十分小心,方向尽量由后上向前下以减小血管神经束损伤的风险,而且螺钉外露的螺纹不宜过长,一般以1到2个螺纹为宜。只要注意锁骨及其重要毗邻结构的解剖特点,体外钢板固定治疗锁骨骨折的安全性是有保障的。Objective To explore anatomic features,adjacent structures and the projection of the clavicle,and provide anatomic basis for treating clavicle fracture through the external plate fixation.Methods 15 adult cadaveric specimens（30 sides） were selected to respectively observe subclavian vessels,brachial plexus,the clavicle and coracoid process.The projection area of the subclavian vessels,brachial plexus on the clavicle was measured and compared.Results Projection area of the neurovascular bundle was at the medial and middle 1/4 segment of the clavicle.Minimal distance from neurovascular bundles to the lower edge of the clavicle was about 0.42 cm and 0.57 cm at the left and right sides respectively.Conclusions During the fixation procedure using the external plate,the hole drilling on the medial and middle 1/4 segment of the clavicle should be careful and directed postsuperiorly to anteroinferierly,and the length of screw have to be considered,for protecting adjacent neurovascular bundles.

关 键 词：锁骨 骨折 外固定 解剖 

分 类 号：R683[医药卫生—骨科学]