摘要
目的对钩骨钩进行应用解剖和影像学研究,为临床诊治钩骨钩和尺神经深支损伤提供实验依据。方法取自愿捐献成人尸体上肢标本52侧,其中防腐标本40侧,新鲜标本12侧;对钩骨钩及其邻近结构进行解剖学观测。随机取其中24侧尸体标本,和正常健康成人12名24侧手为研究对象,行CT三维重建,测量相关数据。采用共用的24侧标本的解剖学和影像学测量数据进行统计学比较。结果钩骨钩是腕尺管和腕管的重要组成部分。尺神经深支在管内紧邻钩骨钩的前内侧。环、小指屈指深肌腱在腕管的最内侧,与钩骨钩的外侧紧密相邻。钩骨位于头状骨和三角骨之间,呈楔形。内、外侧和前侧均为关节面。钩骨钩大体近似扁板状,将其与钩骨体部相移行的部位命名为"钩骨钩基底",钩骨钩中部命名为"钩骨钩腰部",钩骨顶端膨大部命名为"钩骨钩冠部"。基底短径均大于腰部短径。钩骨钩的冠部长径比基底长径和腰部长径大,是钩骨钩的最大长径。两种方法检测钩骨钩的形状和各部解剖特点基本一致,其基底长径、基底短径、腰部长径、腰部短径、冠部长径、钩骨钩高和顶腰距比较差异均无统计学意义(P>0.05)。结论钩骨钩可分为冠部、腰部和基底部;钩骨骨折分为钩骨体骨折、钩骨钩骨折、钩骨体和钩骨钩均有骨折3型;钩骨钩骨折或骨折不愈合易损伤尺神经深支和环、小指屈指深肌腱;CT三维影像测量值可直接作为临床参考值。
Objective To study the hook of hamate bone by anatomy and iconography methods in order to provide information for the clinical treatment of injuries to the hook of hamate bone and the deep branch of ulnar nerve.Methods Fifty-two upper limb specimens of adult corpses contributed voluntarily were collected,including 40 antisepticized old specimens and 12 fresh ones.The hook of hamate bone and its adjacent structure were observed.Twenty- four upper limbs selected randomly from specimens of corpses and 24 upper limbs from 12 healthy adults were investigated by computed tomography（CT）three-dimensional reconstruction,and then related data were measured.The measurement results of 24 specimens were analyzed statistically.Results The hook of hamate bone is an important component of ulnar carpal canal and carpal canal,and the deep branch of ulnar nerve is located closely in the inner front of the hook of hamate bone.The flexor tendons of the forth and the little fingers are in the innermost side,closely lie next to the outside of the hook of hamate bone.The hamate bone located between the capitate bone and the three-cornered bone with wedge-shaped.The medial-,lateral-,and front-sides are all facies articularis.The hook of hamate bone has an approximate shape of a flat plate.The position migrated from the body of the hamate bone,the middle of the hook and the enlargement of the top of the hook were given the names of＂the basis of the hook＂,＂the waist of the hook＂,and＂the coronal of the hook＂,respectively.The short path of the basement are all longer than the short path of the waist.The long path of the top of the hook is the maximum length diameter of the hook of hamate bone,and is longer than the long path of the basement and the long path of the waist.The iconography shape and trait of the hook of hamate bone is similar to the anatomy result.There were no statistically significant differences（P0.05）between two methods in the seven parameters as follows：the long path of the basement of the hook,the short path of the basement of the hook,the long path of the waist of the hook,the short path of the waist of the hook,the long path of the top of the hook,the height of the hook,of hamate bone,and the distance between the top and the waist of the hook.Conclusion The hook of hamate bone can be divided into three parts：the coronal part,the waist part,and the basal part;fracture of the hamate bone can be divided into fracture of the body,fracture of the hook,and fracture of the body and the hook.Facture of the hook of hamate bone or fracture unnion can easily result in injure of the deep branch of ulnar nerve and the flexor tendons of the forth and the little fingers.The measurement results of CT three-dimensional reconstruction can be used as reference value directly in clinical treatments.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第1期60-63,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
钩骨钩
骨折
尺神经深支
应用解剖
CT三维重建
Hook of hamate bone Fracture Deep branch of ulnar nerve Applied anatomy CT three-dimensional reconstruction
