本文選題：順行髓內(nèi)釘　切入點(diǎn)：短外旋肌　出處：《解剖學(xué)報(bào)》2017年03期 　論文類型：期刊論文

【摘要】：目的旨在髓內(nèi)釘手術(shù)進(jìn)針點(diǎn)術(shù)語(yǔ)的標(biāo)準(zhǔn)化,探索股骨近端可靠的骨性標(biāo)志與周圍軟組織的解剖學(xué)關(guān)系。方法查閱關(guān)于順行髓內(nèi)釘進(jìn)針點(diǎn)的文獻(xiàn),重點(diǎn)關(guān)注"梨狀窩"和"轉(zhuǎn)子窩"兩個(gè)術(shù)語(yǔ)。選取國(guó)人成人股骨干標(biāo)本130例,分析轉(zhuǎn)子窩與大轉(zhuǎn)子的關(guān)系。選取國(guó)人成人尸體下肢標(biāo)本20例,觀察股骨近端軟組織附著,測(cè)量梨狀肌、閉孔內(nèi)肌和閉孔外肌肌腱相關(guān)數(shù)據(jù)。結(jié)果 (1)如果沒有梨狀窩則轉(zhuǎn)子窩是髓內(nèi)釘標(biāo)準(zhǔn)的進(jìn)針點(diǎn)。(2)樣本中3.85%的大轉(zhuǎn)子完全不遮擋轉(zhuǎn)子窩,76.15%的大轉(zhuǎn)子包繞轉(zhuǎn)子窩但不遮擋,20.00%部分遮擋。(3)梨狀肌縱徑和橫徑的均值分別為(6.74±1.21)mm和(4.29±1.37)mm,閉孔內(nèi)肌縱徑和橫徑的均值分別為(6.36±1.74)mm和(5.74±1.61)mm,閉孔外肌縱徑和橫徑的平均值分別為(6.26±1.13)mm和(4.57±1.26)mm。(4)梨狀肌附著點(diǎn)前、后緣距大轉(zhuǎn)子后緣的距離占大轉(zhuǎn)子長(zhǎng)度的百分比分別為(57.9±8.8)%和(43.8±8.7)%,閉孔內(nèi)肌的分別為(65.6±7.3)%和(52.6±6.9)%。結(jié)論所謂的梨狀窩應(yīng)被稱為轉(zhuǎn)子窩;因?yàn)榇筠D(zhuǎn)子與轉(zhuǎn)子窩不同的關(guān)系,股骨釘?shù)倪M(jìn)針點(diǎn)是可變的,轉(zhuǎn)子窩不能被視為通用的進(jìn)針點(diǎn);肌腱的定量數(shù)據(jù)有助于優(yōu)化手術(shù)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 鹵1.21 mm and 4.29 鹵1.37 mm respectively, the mean longitudinal and transverse diameters of the internal obturator muscles were 6.36 鹵1.74 mm and 5.74 鹵1.61 mm, the mean values of longitudinal and transverse diameters of the external obturator muscles were 6.26 鹵1.13 mm and 4.57 鹵1.26 mm. The distance from the posterior edge to the posterior edge of the great rotor is 57.9 鹵8.8% and 43.8 鹵8.7% respectively, and the internal obturator muscle is 65.6 鹵7.3% and 52.6 鹵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.
【作者單位】： 鄭州大學(xué)基礎(chǔ)醫(yī)學(xué)院人體解剖學(xué)系;鄭州大學(xué);
【分類號(hào)】：R322.7;R687.3

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