本文選題：肱骨 + 解剖研究�。� 參考：《南華大學(xué)》2007年碩士論文

【摘要】： 目的:研究國(guó)人肱骨近端解剖結(jié)構(gòu)關(guān)系,探討其在肩關(guān)節(jié)置換肱骨頭假體植入和肱骨近端骨折復(fù)位接骨板內(nèi)固定時(shí)的定位參考價(jià)值。 方法:(1).肱骨標(biāo)本直接測(cè)量法,對(duì)60具正常成人干燥肱骨標(biāo)本進(jìn)行解剖形態(tài)學(xué)測(cè)量:①肱骨頭中軸與肱骨結(jié)節(jié)間溝所成角度的測(cè)定;②肱骨結(jié)節(jié)間溝與肱骨大、小結(jié)節(jié)聯(lián)線所成角度的測(cè)定;③肱骨結(jié)節(jié)間溝與肱骨干縱軸所成角度的測(cè)定;確定肱骨頭中軸與肱骨大結(jié)節(jié)下方的肱骨外側(cè)平面交點(diǎn)位置,以此點(diǎn)為定位點(diǎn),④測(cè)量定位點(diǎn)到肱骨大結(jié)節(jié)頂點(diǎn)的距離;⑤測(cè)量大結(jié)節(jié)頂點(diǎn)到肱骨頭頂點(diǎn)的距離;⑥測(cè)量小結(jié)節(jié)頂點(diǎn)到肱骨頭頂點(diǎn)的距離;⑦測(cè)量三角肌粗隆近端到肱骨頭頂點(diǎn)的距離;⑧測(cè)量定位點(diǎn)到肱骨結(jié)節(jié)間溝外側(cè)壁的距離;⑨大結(jié)節(jié)頂點(diǎn)到肱骨頭中心的垂直距離;⑩大結(jié)節(jié)頂點(diǎn)到肱骨頭下端的垂直距離。將測(cè)定數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。 (2).用X線片測(cè)量上述①②③④⑤⑥⑦⑨⑩各項(xiàng)指標(biāo)。將測(cè)定數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,并將肱骨標(biāo)本直接測(cè)量法與X線片測(cè)量法所得數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。(3).用CT掃描肱骨近端研究肱骨頭縱軸與結(jié)節(jié)間溝的關(guān)系 結(jié)果:(1).肱骨標(biāo)本直接測(cè)量法:①肱骨頭中軸與肱骨結(jié)節(jié)間溝所成角度為58.1°±3.2°,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。②肱骨結(jié)節(jié)間溝與肱骨大、小結(jié)節(jié)聯(lián)線所成角度65.8°±6.3°,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。③肱骨結(jié)節(jié)間溝與肱骨干縱軸所成角度為9.7°±1.8°,左右對(duì)比有統(tǒng)計(jì)學(xué)差異(P0.05)。性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。④定位點(diǎn)到肱骨大結(jié)節(jié)頂點(diǎn)的距離為28.3±3.8 m m,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。⑤大結(jié)節(jié)頂點(diǎn)到肱骨頭頂點(diǎn)的距離為4.5±1.4mm,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。⑥小結(jié)節(jié)頂點(diǎn)到肱骨頭頂點(diǎn)的距離為13.6±2.8mm,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。⑦三角肌粗隆近端到肱骨頭頂點(diǎn)的距離為100.1±9.5mm,左右對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。性別對(duì)比有統(tǒng)計(jì)學(xué)差異(P0.05)。⑧定位點(diǎn)到肱骨結(jié)節(jié)間溝外側(cè)壁的距離為7.5±1.9mm,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。⑨大結(jié)節(jié)頂點(diǎn)到肱骨頭中心的垂直距離為17.9±3.3mm;左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。⑩大結(jié)節(jié)頂點(diǎn)到肱骨頭下端的垂直距離為32.4±5.3 mm;左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。(2) .用X線片測(cè)量法:X①肱骨頭中軸與肱骨結(jié)節(jié)間溝所成角度為58.7°±3.6°,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。X②肱骨結(jié)節(jié)間溝與肱骨大、小結(jié)節(jié)聯(lián)線所成角度為65.3°±7.6°,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。X③肱骨結(jié)節(jié)間溝與肱骨干縱軸所成角度為8.5°±1.6°,左右對(duì)比有統(tǒng)計(jì)學(xué)差異(P0.05)。性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。X④定位點(diǎn)到肱骨大結(jié)節(jié)頂點(diǎn)的距離為26.8±3.5 m m,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。X⑤大結(jié)節(jié)頂點(diǎn)到肱骨頭頂點(diǎn)的距離為4.6±1.5 mm,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。X⑥小結(jié)節(jié)頂點(diǎn)到肱骨頭頂點(diǎn)的距離為12.7±2.6 mm,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。X⑦三角肌粗隆近端到肱骨頭頂點(diǎn)的距離為100.9±8.9 mm,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。X⑨大結(jié)節(jié)頂點(diǎn)到肱骨頭中心的垂直距離為18.2±3.2 mm,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。X⑩大結(jié)節(jié)頂點(diǎn)到肱骨頭下端的垂直距離為31.8±5.2 mm,左右及性別對(duì)比無統(tǒng)計(jì)學(xué)差異(P0.05)。骨性標(biāo)本直接測(cè)量法與X線片測(cè)量法所得各項(xiàng)數(shù)據(jù)進(jìn)行對(duì)比統(tǒng)計(jì)學(xué)分析有無統(tǒng)計(jì)學(xué)差異(P0.05)。(3).用CT掃描肱骨近端研究肱骨頭縱軸與結(jié)節(jié)間溝的關(guān)系:從肱骨上端開始橫行掃描,每3mm一層,共15層,選擇相應(yīng)的8層進(jìn)行分析:①肱骨近端得出肱骨頭縱軸到肱骨結(jié)節(jié)間溝外側(cè)壁的距離,平均數(shù)據(jù)分別是: 8.0mm, 7.9mm, 7.6mm,7.5mm, 7.4mm,7.7 mm 7.8mm,8.1mm。②肱骨頭縱軸到肱骨結(jié)節(jié)間溝內(nèi)側(cè)壁的距離,平均數(shù)據(jù)分別18.2mm,18.0mm,16.9 mm,15.8mm,16.3 mm,17.5mm,17.7mm,18.1 mm。 結(jié)論:肱骨近端解剖關(guān)系的研究,對(duì)于國(guó)人肩關(guān)節(jié)置換術(shù)正確掌握肱骨頭假體高度及后傾角以及肱骨近端骨折接骨板內(nèi)固定內(nèi)置物的定位有參考價(jià)值。
[Abstract]:Objective: To study the relationship between the anatomical structure of the proximal humerus of the Chinese people and explore the reference value for the positioning of the humerus prosthesis with the replacement of the shoulder joint and the internal fixation of the proximal humerus fracture with the reduction of the plate.
Methods: (1) direct measurement of humeral specimens of humerus specimens, 60 normal adult humerus specimens were anatomic and morphologically measured: (1) measurement of the angle between the middle axis of the humerus and the humerus tubercle, and the measurement of the angle between the humerus tubercle and the large humerus and the small nodule, and the measurement of the angle of the humerus tubercle and the longitudinal axis of the humerus. Determine the location of the lateral plane of the lateral humerus below the humeral head and the large tubercle of the humerus, and measure the distance between the point of the location and the vertex of the humerus tubercle; (5) measure the distance from the vertex of the large tubercle to the vertex of the humerus; (6) measure the distance from the vertex of the small tubercle to the vertex of the humerus; and measure the proximal end of the deltoid to the humerus. The distance from the vertex to the lateral wall of the humerus tubercle; the vertical distance from the vertex of the large tubercle to the center of the humerus; the vertical distance from the vertex of the large tubercle to the lower end of the humeral head. The measured data were statistically analyzed.
(2) to measure the indexes of the above ((2) (4) (4) (6). Statistical analysis of the measured data and the statistical analysis of the data obtained by the direct measurement of the humerus specimen and the X-ray measurement. (3) the relationship between the longitudinal axis of the humerus and the internode sulcus with the proximal humerus was scanned with CT
Results: (1) the direct measurement of humeral specimens: (1) the angle between the middle axis of the humerus and the humerus tubercle is 58.1 + 3.2 degrees, and there is no statistical difference between the right and the right and the sex (P0.05). 2. The angle of the humerus tubercle is between the humerus and the humerus, the angle of the small nodule line is 65.8? 6.3 degrees, and there is no statistical difference between the right and the right and the sex (P0.05). The angle of the longitudinal axis of the humerus was 9.7 + 1.8 degrees (P0.05). There was no statistical difference between the left and the right (P0.05). (4) the distance between the location point and the vertex of the large tubercle of the humerus was 28.3 + 3.8 m m, and there was no statistical difference between the right and the sex (P0.05). 5. The distance between the vertex of the large tubercle to the vertex of the humerus was 4.5 + 1.4mm, and the difference was about 4.5 + 1.4mm There was no statistical difference in gender (P0.05). 6. The distance between the vertex of the small nodule to the vertex of the humeral head was 13.6 + 2.8mm, and there was no statistical difference between the right and the left and the right (P0.05). The distance between the proximal end of the tricus deltoid and the vertex of the humerus was 100.1 + 9.5mm, and there was no statistical difference between the right and left (P0.05). The gender contrast was statistically different (P0.05). The distance to the lateral wall of the humerus tubercle was 7.5 + 1.9mm, and there was no statistical difference between the left and the right and the sex (P0.05). The vertical distance from the apex to the center of the humerus was 17.9 + 3.3mm, and there was no statistical difference between the left and the right and the sex (P0.05). The vertical distance from the apex of the large tubercle to the lower end of the humerus was 32.4 + 5.3 mm; No statistical difference (P0.05) (2). (2) X-ray measurement: X (1) the angle between the middle axis of the humerus and the humerus tubercle was 58.7 + 3.6 degrees, and there was no statistical difference between the left and right and the sex (P0.05).X. The angle of the humerus tubercle and the humerus was large, the angle of the small nodule line was 65.3 + 7.6 degrees, and there was no statistical difference between the left and the right and the sex (P0.05). The angle between the humeral tubercle and the longitudinal axis of the humeral diaphysis was 8.5 + 1.6 degrees (P0.05). There was no statistical difference (P0.05) the distance between the location of.X (P0.05) and the apex of the large tubercle of the humerus was 26.8 + 3.5 m m, and there was no statistical difference between the left and right and the sex differences (P0.05) the vertex of the large nodule to the apex of the humeral head. The difference was 4.6 + 1.5 mm, and there was no statistical difference between the left and right and the sex (P0.05).X 6. The distance between the vertex of the small nodule to the vertex of the humerus was 12.7 + 2.6 mm, and there was no statistical difference between the left and right and the sexes (P0.05), the distance from the proximal end of the deltoid deltoid to the vertex of the humerus was 100.9 + 8.9 mm, and there was no statistical difference between the left and the right and the sex (P0.05). The vertical distance from the tubercle to the center of the humeral head was 18.2 + 3.2 mm, and there was no statistical difference between the left and right and the sex contrast (P0.05), the vertical distance from the apex of.X to the lower end of the humeral head was 31.8 + 5.2 mm, and there was no statistical difference between the left and right and the sex (P0.05). The direct measurement of bone specimens was compared with the data obtained by X-ray measurement. Statistical analysis (P0.05). (3) the relationship between the longitudinal axis of the humerus and the trench of the humerus was scanned with CT: the transverse scans of the humerus were scanned from the upper end of the humerus, 15 layers per 3mm layer, and the corresponding 8 layers were selected: (1) the distance of the proximal humerus longitudinal axis to the lateral sulcus of the humerus tubercle and the average data were obtained. 8.0mm, 7.9MM, 7.6mm, 7.5mm, 7.4mm, 7.7 mm 7.8mm, 8.1mm. (2) the distance between the longitudinal axis of the humerus and the medial wall of the humerus tubercle. The average data were 18.2mm, 18.0mm, 16.9 mm, 15.8mm, 16.3, 18.1
Conclusion: the study of the proximal humerus anatomical relationship is of reference value for the correct mastery of the height and the obliquity of the humeral head prosthesis and the fixation of the internal fixator of the proximal humerus fracture of the humerus.
【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R687.1;R322

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