肘关节镜前外侧入路安全性初探

发布时间：2018-05-22 07:43

本文选题：肘关节镜 + 入路　；参考：《中国微创外科杂志》2017年06期

【摘要】：目的探讨3种肘关节镜前外侧入路定位点与桡神经(深支)的解剖关系。方法选用福尔马林浸泡的成人肘关节标本10个,对3个不同的肘关节镜前外侧入路点(入路A:肱骨外上髁远端3 cm,前方1 cm;入路B:肱骨外上髁远端2cm,前方2 cm;入路C:肱骨外上髁远端1 cm,前方1 cm)定位、解剖,测量伸直位和屈曲90°位与桡神经(深支)的最近距离。结果前外侧入路A、B、C伸直位与桡神经(深支)的最近距离分别为(2.30±0.95)、(3.00±1.56)、(3.60±1.65)mm,有统计学差异(F=11.097,P=0.001),前外侧入路C距离桡神经(深支)最远,前外侧入路A与C与桡神经(深支)的最近距离有统计学差异(P=0.006),入路A与B、B与C无统计学差异(P_(A-B)=0.134,P_(B-C)=0.072)。前外侧入路A、B、C屈曲90°位与桡神经(深支)的最近距离分别为(4.40±2.01)、(6.10±1.79)、(7.90±1.85)mm,有统计学差异(F=54.775,P=0.000),前外侧入路C距离桡神经(深支)最远,3种入路两两比较均有统计学差异(P_(A-B)=0.000,P_(A-C)=0.000,P_(B-C)=0.002)。体位由伸直位变屈曲90°位时,前外侧入路A点与桡神经距离明显增加(t=-5.161,P=0.001),B点与桡神经距离明显增加(t=-8.188,P=0.000),C点桡神经距离明显增加(t=-10.167,P=0.000)。结论肘关节镜前外侧入路点在肱骨外上髁远端1 cm,前方1 cm最安全。
[Abstract]:Objective to investigate the anatomical relationship between three anterior and lateral approaches of elbow joint and radial nerve (deep branch). Methods Ten adult elbow joint specimens soaked in formalin were used. Three different anterolateral approach points of elbow joint (A: 3 cm at the distal end of the lateral epicondyle of the humerus, 1 cm in front of the lateral epicondyle of humerus, 2 cm in front of the distal end of the lateral epicondyle of humerus, 2 cm in front, 2 cm in the distal end of the lateral epicondyle of humerus, C: 1 cm, 1 cm in front of the lateral epicondyle of humerus) were located and dissected. The nearest distance between extensional position and 90 掳flexion position and radial nerve (deep branch) was measured. Results the closest distance between the extension position of Agnor BANC and the radial nerve (deep branch) was 2.30 卤0.95mm. the distance was 3.00 卤1.56mm. there was statistical difference between the two groups. The distance between the anterior lateral approach and the radial nerve (deep branch) was the furthest from C to the radial nerve (deep branch), there was a statistical difference between the two groups (P < 0.01). The distance between the anterior lateral approach and the radial nerve (deep branch) was the furthest from C to the radial nerve (deep branch). There was significant difference in the nearest distance between A and C and radial nerve (deep branch) in anterolateral approach. There was no significant difference between A and B and C in approach A and B, and there was no significant difference between A and B in the approach. The closest distance between the anterolateral approach and the radial nerve (deep branch) was 4.40 卤2.01mm. there was a statistical difference between the anterolateral approach and the radial nerve (deep branch). There was a statistical difference in the distance between the anterior lateral approach and the radial nerve (deep branch). The distance between the anterior lateral approach and the radial nerve (deep branch) was 6.10 卤2.91 卤1.79 and 7.90 卤1.85 卤7.90 卤1.85, respectively. The distance between the anterolateral approach C and the radial nerve (deep branch) was significantly different. The distance between point A and radial nerve in anterolateral approach was significantly increased when the position changed from extensional position to flexion position at 90 掳position. The distance between point B and radial nerve was significantly increased, and the distance between point A and radial nerve was increased obviously. Conclusion the anterior lateral approach point of elbow joint is 1 cm at the distal end of the lateral epicondyle of humerus, and 1 cm in front of the lateral epicondyle of humerus.
【作者单位】：西南医科大学附属医院骨关节科;
【基金】：四川省科技厅基金项目(13012)
【分类号】：R687.4

【相似文献】