髓内钉手术进针点的探讨——股骨近端解剖学测量

发布时间：2018-03-15 09:28

本文选题：顺行髓内钉　切入点：短外旋肌　出处：《解剖学报》2017年03期 　论文类型：期刊论文

【摘要】：目的旨在髓内钉手术进针点术语的标准化,探索股骨近端可靠的骨性标志与周围软组织的解剖学关系。方法查阅关于顺行髓内钉进针点的文献,重点关注"梨状窝"和"转子窝"两个术语。选取国人成人股骨干标本130例,分析转子窝与大转子的关系。选取国人成人尸体下肢标本20例,观察股骨近端软组织附着,测量梨状肌、闭孔内肌和闭孔外肌肌腱相关数据。结果 (1)如果没有梨状窝则转子窝是髓内钉标准的进针点。(2)样本中3.85%的大转子完全不遮挡转子窝,76.15%的大转子包绕转子窝但不遮挡,20.00%部分遮挡。(3)梨状肌纵径和横径的均值分别为(6.74±1.21)mm和(4.29±1.37)mm,闭孔内肌纵径和横径的均值分别为(6.36±1.74)mm和(5.74±1.61)mm,闭孔外肌纵径和横径的平均值分别为(6.26±1.13)mm和(4.57±1.26)mm。(4)梨状肌附着点前、后缘距大转子后缘的距离占大转子长度的百分比分别为(57.9±8.8)%和(43.8±8.7)%,闭孔内肌的分别为(65.6±7.3)%和(52.6±6.9)%。结论所谓的梨状窝应被称为转子窝;因为大转子与转子窝不同的关系,股骨钉的进针点是可变的,转子窝不能被视为通用的进针点;肌腱的定量数据有助于优化手术入路。
[Abstract]:Objective to standardize the term of needle point in intramedullary nail operation and to explore the anatomical relationship between reliable bone markers of proximal femur and surrounding soft tissue. The relationship between trochanter fossa and trochanteric fossa was analyzed in 130 Chinese adult femoral shaft specimens. The soft tissue attachment of proximal femur was observed in 20 Chinese cadaveric cadavers. The piriformis muscle was measured, Data relating to the tendons of the internal obturator muscle and the external obturator muscle. Results 1) if there is no piriform fossa, the trochanter fossa is the standard entry point for intramedullary nails.) in the sample, 3.85% of the great trochanter does not block the trochanter fossa completely. 76.15% of the great trochanter wraps around the trochanteric fossa but does not. The mean longitudinal and transverse diameters of piriformis muscle were 6.74 卤1.21 mm and 4.29 卤1.37 mm respectively, the mean longitudinal and transverse diameters of the internal obturator muscles were 6.36 卤1.74 mm and 5.74 卤1.61 mm, the mean values of longitudinal and transverse diameters of the external obturator muscles were 6.26 卤1.13 mm and 4.57 卤1.26 mm. The distance from the posterior edge to the posterior edge of the great rotor is 57.9 卤8.8% and 43.8 卤8.7% respectively, and the internal obturator muscle is 65.6 卤7.3% and 52.6 卤6.9% respectively. Conclusion the so-called piriform fossa should be called the rotorular fossa, because the relationship between the great rotor and the trochanter fossa is different. The needle point of femoral nail is variable, the trochanteric fossa can not be regarded as a common point of needle entry, and the quantitative data of tendon is helpful to optimize the operative approach.
【作者单位】：郑州大学基础医学院人体解剖学系;郑州大学;
【分类号】：R322.7;R687.3

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