改良肩前下入路治疗肱骨近端骨折的解剖学研究  

Anatomical study on modified anterior inferior shoulder approach for treatment of proximal humerus fracture

作　　者：韩笑 朱云华[2] 王晓东[2] HAN Xiao;ZHU Yunhua;WANG Xiaodong(Department of Anatomy,Medical School,Nantong University,Nantong 226001;Department of Orthopaedics,Nantong Third Hospital Affiliated to Nantong University)

机构地区：[1]南通大学医学院人体解剖学系,南通226001 [2]南通大学附属南通第三医院骨科

出　　处：《南通大学学报（医学版）》2021年第6期502-504,共3页Journal of Nantong University(Medical sciences)

基　　金：南通市社会发展计划项目(MSZ18220)。

摘　　要：目的:研究肱骨近端骨折改良肩前下入路腋神经与切口间的解剖关系,为临床手术提供依据。方法:解剖8例成人防腐上肢标本,观察腋神经走行及在切口周围分支情况,测量腋神经及分支与切口周围相关的结构数据。结果:(1)经三角肌前束切口能清晰暴露肱骨上端结节间沟周围结构;(2)腋神经自后向前走行于三角肌内面,逐渐上移,于切口附近发一向上分支;(3)腋神经主干距切口下缘平均距离5.5 mm,腋神经分支距切口平均距离4.3 mm。结论:以肱骨大结节为标定点劈开三角肌前束入路安全可靠,可以作为临床手术治疗肱骨近端骨折的手术入路。Objective:To detect the anatomical relationship between axillary nerve and incision of the modified anterior inferior shoulder approach in proximal humerus fractures,and to provide foundation for clinic.Methods:8 adult cadaveric upper limbs were dissected.The course of axillary nerve and branches surrounding the incision were observed,and the data related to axillary nerve and incision were measured and calculated.Results:(1)The structure around the internodal groove of the humerus were exposed clearly by using the incision via anterior part of deltoid muscle.(2)A branch was given off from axillary nerve near incision when the trunk of it runs along the medial surface of deltoid muscle from posterior edge to anterior edge,moving up gradually.(3)The average distance between the main trunk of axillary nerve and the lower edge of incision was 5.5 mm,and that of axillary nerve branch was 4.3 mm.Conclusion:It is safe and reliable of the incision to split the anterior bundle of deltoid muscle with the greater tuberosity of humerus as calibration point,which can be used as the surgical approach for the treatment of proximal humerus fractures.

关 键 词：肱骨近端骨折 改良肩前下入路 腋神经 解剖 

分 类 号：R683.41[医药卫生—骨科学]