带血管蒂豌豆骨转移替代其他腕骨坏死的解剖学基础

发布时间：2018-02-15 13:04

本文关键词： 豌豆骨腕骨坏死移植解剖学　出处：《山东大学》2006年硕士论文　论文类型：学位论文

【摘要】：目的：观察豌豆骨的血供来源和滋养动脉的分布特点，并测量各滋养动脉的管径和长度，为以带血管蒂豌豆骨转移替代其他腕骨坏死提供解剖学依据。方法：1．解剖20侧新鲜红色乳胶灌注的成人上肢标本，结合局部铸型标本，观察豌豆骨的血供来源及血供分布特点。 2．精确测量豌豆骨主要滋养血管的管径和长度，并对所测数据进行统计学分析。结果：1．豌豆骨的血供来源豌豆骨的滋养动脉主要来自尺动脉、尺动脉腕上皮支下行支和尺动脉掌深支，其周围附着的肌肉、肌腱及韧带的营养血管也直接或间接地营养该骨。 2．豌豆骨周围血供分布特点豌豆骨除背侧与三角骨形成的关节面没有血供分布，其近、远、尺、桡侧均有血供分布。尺动脉1～3条直接小分支自桡侧入骨；尺动脉腕上皮支下行支的豌豆骨支自尺侧和近端入骨；尺动脉掌深支的返支(出现率80％)沿豆-钩韧带尺侧至该骨尺侧和远端入骨。另外，附着在豌豆骨近端的尺侧腕屈肌腱，远端的小指展肌，以及周围的腕横韧带、豆钩韧带、豆掌韧带及尺侧副韧带等，这些组织的血管也直接或间接地营养该骨。 3．豌豆骨的各滋养动脉及其分支分别沿豆—三角关节囊和在豌豆骨周围形成内、外两个动脉环。 4．豌豆骨主要滋养血管的管径和长度 (1)尺动脉腕上皮支自豌豆骨近端以上41.502±5.247mm处从尺动脉的内侧发出，起始段外径1.443±0.070mm。尺动脉腕上皮支又分为上行支与下行支，其下行支起始部外径1.232±0.080mm，发出豌豆骨支分布至豌豆骨尺侧和近端。以尺动脉腕上皮支下行支为蒂转移豌豆骨，血管蒂长度为50.057±
[Abstract]:Objective: to observe the origin of blood supply of pea bone and the distribution of nutrient artery, and to measure the diameter and length of each nutrient artery so as to provide anatomic basis for replacing other carpal osteonecrosis with vascularized pea bone metastasis. Methods: 1. Dissected 20 fresh red latex perfused adult upper limb specimens and observed the blood supply source and blood distribution characteristics of pea bone combined with local cast specimen. 2. The diameter and length of the main nourishing vessels of the pea bone were measured accurately, and the data were analyzed statistically. Results 1. The blood supply of the pea bone came mainly from the ulnar artery, the descending branch of the superior cutaneous branch of the ulnar artery and the deep metacarpal branch of the ulnar artery. The muscles, tendons and ligaments attached thereto also directly or indirectly nourished the bone. 2. Distribution of blood supply around the pea bone; there was no blood supply distribution on the articular surface of the pea bone except the dorsal side and the triangular bone, and there was blood supply distribution in the proximal, distal, ulnar and radial sides. The pea bone branch of the descending branch of the superior cutaneous branch of the ulnar artery enters the bone from the ulnar side and the proximal end; the recurrent branch of the deep branch of the ulnar palmar artery enters the ulnar and distal sides of the bone along the ulnar side of the ligamentum hook. In addition, the tendon of the flexor Carpi ulnaris attached to the proximal end of the pea bone is attached to the ulnar flexor tendon. The distal abductor muscle and the transverse ligaments of the wrist, ligamentum hook, ligamentum palmaris and ulnar collateral ligament are also directly or indirectly nourished the bone. 3. The nutrient arteries and their branches of the pea bone were formed along the capsular of the pea-triangular joint and around the pea bone, respectively. 4. Diameter and length of the main nourishing vessels of the pea bone. 1) the superior cutaneous branch of ulnar artery originated from the medial side of the ulnar artery from 41.502 卤5.247 mm above the proximal end of the pea bone, and the external diameter of the starting segment was 1.443 卤0.070 mm. the superior cutaneous branch of the ulnar artery was further divided into the ascending branch and the descending branch. The origin of the descending branch was 1.232 卤0.080 mm in diameter and distributed to the ulnar and proximal end of the pea bone. The descending branch of the superior cutaneous branch of the ulnar artery was used as the pedicle to transfer the pea bone, and the length of the vascular pedicle was 50.057 卤
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R687;R322

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