尺侧副韧带后束的解剖学特征及临床意义  

Anatomical features of the posterior bundle of the ulnar collateral ligament and clinical significance

作　　者：杨涛 高转 刘炳智 李武超 孙睿哲 郎昱颖 李京 Yang Tao;Gao Zhuan;Liu Bingzhi;Li Wuchao;Sun Ruizhe;Lang Yuying;Li Jing(College of Basic Medicine,Jining Medical University,Jining 272067,Shandong Province,China)

机构地区：[1]济宁医学院基础医学院,山东济宁272067

出　　处：《中国临床解剖学杂志》2024年第2期136-139,共4页Chinese Journal of Clinical Anatomy

基　　金：济宁医学院2023年大学生创新训练计划项目(cx2023171)。

摘　　要：目的 观察肘关节尺侧副韧带(UCL)的解剖学特征,对其后束(PB)进行解剖学分类,为肘关节精确解剖、韧带的外科修复提供参考依据。方法 82例结构完整的人上肢标本,解剖UCL,观察PB的形态特征及变异,依据其与肘关节囊的关系划分类型;测量PB的长度、起点宽度、止点宽度等。结果(1)根据PB与肘关节囊的关系分为:(1)Ⅰ型:PB的前缘及后缘均位于关节囊表面,增厚并游离,呈独立型条带61%(50例);此类型男性、女性PB的长度分别是(20.92±2.59) mm、(17.28±2.07) mm,二者具有显著性差异(P=0.000,t=5.531);(2)Ⅱ型:PB的前缘与肘关节囊融合,后缘增厚游离16%(13例);(3)Ⅲ型:PB的后缘与肘关节囊融合,前缘增厚游离18%(15例);(4)Ⅳ型:PB的前缘、后缘均与肘关节囊融合,难以分辨5%(4例)。(2)男性PB以Ⅰ型与Ⅱ型较多,女性PBⅠ型与Ⅲ型较多,在类型构成方面具有显著性差异(χ^(2)=8.096,P=0.035)。结论 本实验对PB的分型,是对UCL解剖结构的补充;PB呈Ⅱ~Ⅳ等类型可能是导致其变异的重要因素;处理PB损伤时应考虑性别差异,便于结构功能恢复。Objective To clarify the morphological features of the posterior bundle(PB) of the ulnar collateral ligament of the elbow joint,so as to provide reference for anatomy of elbow joint and surgical repairs of ligaments.Methods A total of 82 adult elbow joints were dissected and the characteristics of the PB were noted.The length,widths of the origin and insertion of the PB were measured with a vernier caliber.Results(1)The PB was divided into four types according to the relation with the elbow joint capsule:(1) typeⅠ,the anterior and posterior edges were located on the surface of the capsule and could be separated as a single ligament in 61% of cases.There was significant difference in length between male(20.92±2.59) mm and female(17.28±2.07) mm in this type(P=0.000,t=5.531).(2) type Ⅱ,the anterior edge of PB was fused with elbow joint capsule,while the posterior edge was thickened and free in 16% of cases.(3) type Ⅲ,the posterior edge of PB was fused with elbow joint capsule,while the anterior edge was thickened and free in 18% of cases.(4) type Ⅳ,the anterior and posterior edges of PB could not be separated from the elbow joint capsule in 5% of cases.(2) Types Ⅰand Ⅱ were more commonly occurred in male,while types Ⅰand Ⅲ were observed in female frequently.There was significant difference in type composition(χ^(2)=8.096,P=0.035).Conclusions The new classification of the PB was proposed based on the supplement to the anatomy of UCL,which emphasized the relation with the joint capsule of the elbow Type Ⅱ ~ Ⅳ of PB maybe an important factor causing morphological variation.Gender difference should be considered when treating PB injury,so as to facilitate structural and functional recovery.

关 键 词：尺侧副韧带 后束 变异 应用解剖 

分 类 号：R322.73[医药卫生—人体解剖和组织胚胎学]