本文選題：肩關(guān)節(jié) + 解剖學測量��； 參考：《延邊大學》2017年碩士論文

【摘要】：目的:利用肩關(guān)節(jié)解剖標本觀察喙肩弓的解剖結(jié)構(gòu)和肩關(guān)節(jié)在不同體位時喙肩弓間隙的變化,探討喙肩弓撞擊的發(fā)生機制以及預(yù)防和治療。方法:取16側(cè)肩關(guān)節(jié)尸體標本,全部經(jīng)福爾馬林常規(guī)處理,均已排除肩關(guān)節(jié)的肉眼可見性病變。測量各個肩關(guān)節(jié)標本6個不同體位(包括0°中立位,30°、60°、90°、120°、150°不同外展位)的岡上肌在肱骨頭上止點到肩峰前外側(cè)緣的距離(Acromial supraspinatus distance,ACS)、岡上肌止點到喙肩韌帶外側(cè)緣中點的距離(Coracoacromial ligament supraspinatus distance,CAS),肱骨大結(jié)節(jié)與喙肩韌帶的最大重疊距離,岡上肌肌腱和肩峰下間隙的位置關(guān)系,喙肩韌帶(Coracoacromial ligament,CAL)的前底、后底、內(nèi)側(cè)邊和外側(cè)邊,肩峰的長和寬。結(jié)果:ACS值在60°-120°外展角度時明顯小于0°-30°和150°外展角度時(P0.01)。在60°、90°、120°三個不同體位的ACS值無統(tǒng)計學意義上的差異(P0.05)。CAS值在60°-120°外展角度時明顯小于0°-30°和150°外展角度時(P0.01)。在在60°、90°、120°三個不同體位的CAS值無統(tǒng)計學意義上的差異(P0.05)。肱骨大結(jié)節(jié)與喙肩韌帶的最大重疊距離為1.528±0.0.070cm。岡上肌肌腱在初始0°-30°外展角度時,位于肱骨和肩峰最短距離的外側(cè)。60°-90°外展角度時,岡上肌肌腱從喙肩韌帶下穿過,在肩峰與肱骨頭前內(nèi)側(cè)。90°-120°外展角度時,岡上肌肌腱從肩峰和肱骨頭之間穿過。在150°外展角度時岡上肌肌腱偏向于肩峰與肱骨頭后內(nèi)方。CAL前底為4.006±0.208cm,后底為 2.468±0.208cm,內(nèi)側(cè)邊為 3.996±0.166cm,外側(cè)邊為 4.603±0.210cm。肩峰的長為 4.080±0.124cm,寬為 2.470±0.180cm。結(jié)論:1.肩關(guān)節(jié)外展60°-120°時,喙肩弓間隙比較小,此時容易發(fā)生肩峰下撞擊,臨床上肩峰撞擊患者應(yīng)避免此類運動,防止加重病情惡化。2.通過研究喙肩弓的解剖形態(tài),為如何對喙肩弓進行充分松解和成形提供數(shù)據(jù)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 擄neutral position 30 擄60 擄60 擄90 擄90 擄120 擄150 擄) 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 擄-120 擄outreaching angle was significantly lower than that at 0 擄-30 擄and 150 擄abduction angle (P 0.01). There was no significant difference in ACS values among the three different positions at 60 擄-90 擄and 120 擄. The ACS value was significantly smaller than that of 0 擄-30 擄and 150 擄abduction angles at 60 擄-120 擄outreaching angle. There was no significant difference in CAS values in three different postures at 60 擄to 90 擄and 120 擄(P 0.05). The maximum overlap distance between the greater tubercle of humerus and the coracoacromian ligament was 1.528 鹵0.0.070 cm. At the initial abduction angle of 0 擄-30 擄, and at the lateral. 60 擄-90 擄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 擄abduction, the tendons of supraspinatus muscle were 4.006 鹵0.208 cm, 2.468 鹵0.208 cm, 3.996 鹵0.166 cm and 4.603 鹵0.210 cm at the anterior floor, 2.468 鹵0.208 cm, 3.996 鹵0.166 cm and 4.603 鹵0.210 cm, respectively. The length and width of acromion were 4.080 鹵0.124 cm and 2.470 鹵0.180 cm respectively. Conclusion 1. When the shoulder joint abduction is 60 擄-120 擄, 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.
【學位授予單位】：延邊大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687;R322
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本文編號：1843077