喙肩弓的解剖学特点及其临床意义

发布时间：2018-05-04 12:32

  本文选题：肩关节 + 解剖学测量　； 参考：《延边大学》2017年硕士论文

【摘要】：目的:利用肩关节解剖标本观察喙肩弓的解剖结构和肩关节在不同体位时喙肩弓间隙的变化,探讨喙肩弓撞击的发生机制以及预防和治疗。方法:取16侧肩关节尸体标本,全部经福尔马林常规处理,均已排除肩关节的肉眼可见性病变。测量各个肩关节标本6个不同体位(包括0°中立位,30°、60°、90°、120°、150°不同外展位)的冈上肌在肱骨头上止点到肩峰前外侧缘的距离(Acromial supraspinatus distance,ACS)、冈上肌止点到喙肩韧带外侧缘中点的距离(Coracoacromial ligament supraspinatus distance,CAS),肱骨大结节与喙肩韧带的最大重叠距离,冈上肌肌腱和肩峰下间隙的位置关系,喙肩韧带(Coracoacromial ligament,CAL)的前底、后底、内侧边和外侧边,肩峰的长和宽。结果:ACS值在60°-120°外展角度时明显小于0°-30°和150°外展角度时(P0.01)。在60°、90°、120°三个不同体位的ACS值无统计学意义上的差异(P0.05)。CAS值在60°-120°外展角度时明显小于0°-30°和150°外展角度时(P0.01)。在在60°、90°、120°三个不同体位的CAS值无统计学意义上的差异(P0.05)。肱骨大结节与喙肩韧带的最大重叠距离为1.528±0.0.070cm。冈上肌肌腱在初始0°-30°外展角度时,位于肱骨和肩峰最短距离的外侧。60°-90°外展角度时,冈上肌肌腱从喙肩韧带下穿过,在肩峰与肱骨头前内侧。90°-120°外展角度时,冈上肌肌腱从肩峰和肱骨头之间穿过。在150°外展角度时冈上肌肌腱偏向于肩峰与肱骨头后内方。CAL前底为4.006±0.208cm,后底为 2.468±0.208cm,内侧边为 3.996±0.166cm,外侧边为 4.603±0.210cm。肩峰的长为 4.080±0.124cm,宽为 2.470±0.180cm。结论:1.肩关节外展60°-120°时,喙肩弓间隙比较小,此时容易发生肩峰下撞击,临床上肩峰撞击患者应避免此类运动,防止加重病情恶化。2.通过研究喙肩弓的解剖形态,为如何对喙肩弓进行充分松解和成形提供数据支持。
[Abstract]:Objective: to observe the anatomical structure of the coracoacromion arch and the changes of the space between the coracoacromion arch in different postures, and to explore the mechanism, prevention and treatment of coracoacromion arch impact. Methods: 16 shoulder cadavers were treated with formalin. The distance of supraspinatus muscle from the superior humerus to the anterolateral edge of acromium was measured in 6 different positions (including 0 掳neutral position 30 掳60 掳60 掳90 掳90 掳120 掳150 掳) and the distance between the insertion point of the supraspinatus muscle and the middle point of the lateral edge of the coracoacromidium ligament (ACSS) and the distance from the anterior lateral edge of the acromion to the lateral edge of the coracoacromial ligament. From Coracoacromial ligament supraspinatus distanceus, the maximum overlap distance between the greater tubercle of the humerus and the coracoacromian ligament was observed. The relationship between supraspinatus tendon and subacromial space, the anterior, posterior, medial and lateral sides of Coracoacromial ligamentCAL, and the length and width of acromion. Results the ratio of ACS at 60 掳-120 掳outreaching angle was significantly lower than that at 0 掳-30 掳and 150 掳abduction angle (P 0.01). There was no significant difference in ACS values among the three different positions at 60 掳-90 掳and 120 掳. The ACS value was significantly smaller than that of 0 掳-30 掳and 150 掳abduction angles at 60 掳-120 掳outreaching angle. There was no significant difference in CAS values in three different postures at 60 掳to 90 掳and 120 掳(P 0.05). The maximum overlap distance between the greater tubercle of humerus and the coracoacromian ligament was 1.528 卤0.0.070 cm. At the initial abduction angle of 0 掳-30 掳, and at the lateral. 60 掳-90 掳angle of the shortest distance between humerus and acromium, the tendon of supraspinatus muscle passes through the coracoacromion ligament, and at the angle of abduction between the acromium and the anterior medial humerus, the tendon of the supraspinatus muscle passes through the coracoacromion ligament. The supraspinatus tendon passes between the acromion and the head of the humerus. At the angle of 150 掳abduction, the tendons of supraspinatus muscle were 4.006 卤0.208 cm, 2.468 卤0.208 cm, 3.996 卤0.166 cm and 4.603 卤0.210 cm at the anterior floor, 2.468 卤0.208 cm, 3.996 卤0.166 cm and 4.603 卤0.210 cm, respectively. The length and width of acromion were 4.080 卤0.124 cm and 2.470 卤0.180 cm respectively. Conclusion 1. When the shoulder joint abduction is 60 掳-120 掳, the space of coracoacromion arch is relatively small, it is easy to happen subacromial impact at this time. In clinic, patients with acromion impact should avoid this kind of exercise and prevent from aggravating the condition. 2. The anatomic morphology of coracoacromion arch is studied to provide data support for fully releasing and forming coracoacromic arch.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687;R322
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