同济大学学报（医学版）2012，Vol.33Issue(1)：19-23,5.DOI:10.3969/j.issn1008-0392.2012.01.004
肩外侧小切口内固定治疗肱骨近端骨折的解剖学研究
Applied anatomy of anterolateral transverse incision in treatment of proximal humeral fractures
孙万驹 1王子彬 2蔡俊丰 1倪明1
作者信息
- 1. 同济大学附属东方医院骨科,上海200120
- 2. 上海市浦东新区人民医院骨科,上海201200
- 折叠
摘要
Abstract
Objective To provide anatomic basis for clinical application of anterolateral transverse incision for treatment of proximal humeral fractures. Methods The distances between the axillary nerve to culminating point of greater tuberosity and superior border of acromial bone were measured on 30 cadaveric shoulder joints. And K-wires were inserted from greater tuberosity toward to intero-inferiorly for stabilize the fractured greater tuberosity. The relationship of K-wires with humeral neck, the nerves and the arteries were observed on the shoulder joints after insertion of pins. Results The distances from axillary nerve to culminating point of greater tuberosity and superior border of acromial bone were (34. 1 ±3.7) mm and (53.4 ±5. 8) mm, respectively. The distances from standard line to culminating point of greater tuberosity were (31. 8 ±2. 8) mm. When pin was inserted on the 1. 5 times distances from standard line to culminating point of greater tuberosity, it would not injury the nerves. When inserted from greater tuberosity toward intero-inferiorly with 60° would not injury the nerves and the arteries. Conclusion The anatomic study suggests that with the anterolateral acromial approach, 0 ~ 3 cm below greater tuberosity is relative safe area and proper manipulation of pin insertion would avoid nerve and artery injury.The point insert pin is far away 1. 5 times from the distances from standard line to culminated point of greater tuberosity. When insert from greater tuberosity toward to intero-inferiorly with 60°, the K-wires always won't injury the nerve and the arteries.关键词
小切口/肱骨近端骨折/解剖/克氏针Key words
minimal incision/ proximal humeral fracture/ anatomy/K-wire分类
医药卫生引用本文复制引用
孙万驹,王子彬,蔡俊丰,倪明..肩外侧小切口内固定治疗肱骨近端骨折的解剖学研究[J].同济大学学报（医学版）,2012,33(1):19-23,5.
