大、小多角骨形态与血供的解剖学研究  

Anatomical research on the morphology and blood supply of the trapezium bone and trapezoid bone

作　　者：王雅康 徐永清[1] 袁礼波 张旭林[1] 许育健 罗浩天[1] 魏明杰 Wang Yakang;Xu Yongqing;Yuan Libo;Zhang Xulin;Xu Yujian;Luo Haotian;Wei Mingjie(920th Hospital of Joint Logistics Support Force Affiliated to Kunming Medical University,Kunming 650032,China;Army Military Medical University,Chongqing 400000,China)

机构地区：[1]昆明医科大学附属联勤保障部队第九二〇医院,昆明650032 [2]陆军军医大学,重庆400000

出　　处：《中国临床解剖学杂志》2021年第2期134-139,共6页Chinese Journal of Clinical Anatomy

基　　金：云南省钟世镇院士工作站资助项目(2015IC030)。

摘　　要：目的三维立体建模观察大、小多角骨形态及血供模式,探究其临床意义。方法选取腕标本12例,将明胶-氧化铅灌注液注入腕标本后行Micro-CT扫描,所得数据导入Mimics软件进行三维重建,观察大、小多角骨形态,记录滋养孔数目与位置,分析骨内血管吻合及走行。结果(1)大多角骨有一定数目的滋养孔分布在3侧非关节面,桡侧(2.66±0.49)个,背侧(2.75±0.62)个,掌侧(2.33±0.65)个,3侧数目两两比较无统计学差异,骨内血管有数级分支且广泛吻合,约70%来自背侧,30%来自掌侧和桡侧;(2)小多角骨有一定数目的滋养孔分布在两侧非关节面,背侧(2.75±0.45)个,掌侧(2.42±0.51)个,两侧数目比较无统计学差异,骨内血管亦有数级分支,但分支吻合不如大多角骨丰富,约70%来自背侧,30%来自掌侧。结论(1)大多角骨内外血供丰富,可能是大多角骨相较其他腕骨不易发生缺血性骨坏死的原因;(2)小多角骨外血供较为丰富,但骨内血管吻合少于大多角骨,这可能是小多角骨相对大多角骨更易发生非创伤性缺血性骨坏死的主要原因。Objective To observe the morphology and blood supply pattern of the trapezium bone and trapezoid bone,and provide reasonable anatomical basis for the clinical application.Methods Twelve wrist specimens were perfused with a mixture of lead oxide and gelatin powder into the main arteries of the wrist.After the perfusion,the Micro-CT scan was performed.The scanning data were imported into the software of Mimics for three-dimensional reconstruction.The morphology of the trapezium bone and trapezoid bone was observed,the number and location of the nutrient foramens were recorded,and the anastomosis and course of the blood vessels in the bone were analyzed.Results(1)The trapezium bone had a relatively constant number of nutrient foramen distributed on the three non-articular surfaces,which was(2.66±0.49)foramen on the radial side,(2.75±0.62)foramen on the dorsal side,and(2.33±0.65)foramen on the volar side,there were no statistical difference in the number of nutrient foramen among the three nonarticular sides.The nourishing blood vessels branched out after penetrating into the bone and widely anastomosed with each other.About 70%of the blood supply in the bone came from the dorsal side,while30%came from the volar and radial sides.(2)The trapezoid bone had a relatively constant number of nutrient foramen distributed on the two non-articular surfaces,(2.75±0.45)foramen on the dorsal side,and(2.42±0.51)foramen on the volar side,there were no statistical difference in the number of nutrient foramens between the two non-articular sides.The nourishing blood vessels branched out after penetrating into the bone,but its intraosseous blood vessel branch anastomosis was not as rich as that of the trapezium bone.About 70%of the blood supply in the bone came from the dorsal side,and 30%came from the volar side.Conclusions(1)The trapezium bone is rich in nourishing blood vessels from inside and outside the bone,which may be the reason why the incidence of the trapezium bone avascular necrosis is lower than other carpal bones.(

关 键 词：大多角骨 小多角骨 缺血性骨坏死 血管灌注 MIMICS 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R602[医药卫生—基础医学]