肩锁关节形态学及组织结构特点  

Morphology and tissue structure of acromioclavicular joint

作　　者：周日 谢小肖 王霜[1] 任士友 张文涛[1] ZHOU Ri;XIE Xiao-xiao;WANG Shuang;REN Shi-you;ZHANG Wen-tao(Department of Sports Medicine,Peking University Shenzhen Hospital,Guangdong Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院运动医学科,广东深圳518036

出　　处：《解剖学报》2022年第1期103-107,共5页Acta Anatomica Sinica

基　　金：深圳市三名工程项目(SZSM201612078)。

摘　　要：目的探讨肩锁关节形态学及组织结构特点。方法对27具成人新鲜尸体进行解剖学分析,观察肩锁关节形态,测量相关骨性结构、韧带参数,并将标本随机分为A、B两组,A组保留肩锁韧带和喙锁韧带,B组仅保留肩锁韧带,比较两组之间承受拉力的差别。结果锥状韧带止点中点到锁骨远端距离(42.68±6.34)mm,止点宽度(16.97±4.28)mm,中心点厚度为(5.39±0.34)mm;斜方韧带止点中点到锁骨远端度距离(20.35±4.18)mm,止点宽度(10.35±1.31)mm,中心点厚度为(5.19±0.342)mm;喙突基底底部到锁骨表面的垂直平均距离为30.75 mm,喙锁间隙平均距离为12.02 mm;锥韧带中轴长度为(15.68±3.30)mm,角度(117.25±10.80)°,而斜方韧带中轴长度为(9.67±2.25)mm,角度(75.42±11.37)°,锥状韧带和斜方韧带始点距离(8.96±3.00)mm,止点距离(13.09±3.50)mm;A组拉力平均值(610.04±51.24)N高于B组拉力平均值(560.41±44.63)N(P<0.05)。结论在行锁骨远端切除术时,锁骨远端切除应控制在10~30 mm之间,在喙突下方上钻孔时深度尽量不超过42 mm,肩锁关节脱位时重建喙锁韧带具有解剖学及生物力学基础。Objective To explore the morphology and the tissue structure of acromioclavicular joint.Methods Anatomical analysis was performed on 27 fresh adult cadavers and the morphology of the acromioclavicular joint was observed.The relevant bone structure and ligament parameters were measured,and the specimens were randomly divided into group A and group B.Group A reserved the acromioclavicular ligament and coracoclavicular ligament,and group B reserved only the acromioclavicular ligament.The difference in tension between the two groups was compared.Results The distance from the midpoint of the conical ligament to the distal end of the clavicle was(42.68±6.34)mm,the width of the end point was(16.97±4.28)mm,and the thickness of the center point was(5.39±0.34)mm;the distance from the midpoint of the trapezoidal ligament to the clavicle was(20.35 mm±4.18)mm,the width of the end point was(10.35±1.31)mm,the thickness of the center point was(5.19±0.342)mm;the average vertical distance from the base of the coracoid process to the surface of the clavicle was 30.75 mm,and the mean coracoclavicular gap was 12.02 mm;the length of the central axis of the conical ligament was(15.68±3.30)mm and the angle was(117.25±10.80)°,while the length of the central axis of the trapezoidal ligament was(9.67±2.25)mm,and the angle was(75.42±11.37)°.The distance between the start joint of the trapezoidal ligament and the trapezium was(8.96±3.00)mm,and the distance between the end points(13.09±3.50)mm.The average tensile force of group A was higher than that of group B[(610.04±51.24)N vs(560.41±44.63)N,P<0.05].Conclusion During distal clavicular resection,the resection of the distal clavicle shall be within 10-30 mm.The depth shall not exceed 42 mm when drilling under the coracoid process.The reconstruction of the coracoclavicular ligament during acromioclavicular joint dislocation has an anatomical and biomechanical basis.

关 键 词：肩锁关节 形态学 骨性结构 解剖学测量 成人 

分 类 号：R324[医药卫生—人体解剖和组织胚胎学]