摘要
目的了解正常胸锁关节、锁骨胸骨端和胸骨柄在CT图像上的径线长度，确定由内固定物向胸骨柄钻孔的安全角度和长度。方法对50名健康志愿者的胸锁关节进行CT扫描成像，成像角度包括矢状面、冠状面和横断面。测量锁骨近端的高度与前后径、锁切迹的长度与前后径、锁切迹与胸骨的成角、胸骨柄与身体长轴的成角、胸骨柄的厚度、胸锁关节间隙大小以及锁骨间距。并确定由内固定物向胸骨柄钻孔的安全角度和长度结果左、右侧的各项测量指标比较，差异均无统计学意义（P〉0．05）。冠状面上胸骨柄锁切迹的长度和锁骨内侧端的长度接近，差异均无统计学意义（P〉0．05）。横断面上锁切迹的前后径比锁骨内侧端的前后径短，差异有统计学意义（P〈0．05）。胸骨后方重要组织中，头臂干、左右头臂静脉贴近胸骨柄的后缘，术中应以安全角度（α〉46°或β〈-49°）进钻，或将进钻深度控制在安全深度（2．38±0．61）cm以内。结论本研究明确了CT图像上正常胸锁关节的特征，并定量描述了胸骨柄与其后方重要组织的伴行关系，对胸锁关节脱位的诊断与治疗提供了参考。
Objective To investigate anatomical features of the sternoclavicular joint on computed tomography （CT） scans to determine the safe angle and length of drilling into the manubrium stcrni for implants. Methods CT scans were taken in 50 healthy human volunteers. Reconstructive images on coronal, sagittal and transverse planes of the sternoclavicular region, from the superior border of the clavicle to the sternal angle, were obtained. Measurements were conducted on the images to determine the height and the anteroposterior dimension of the proximal end of the clavicle, the length and the anteroposterior dimension of the clavicular notch, the angle between the clavicular notch and the sternum, the angle between the manubrium sterni and the trunk, thickness of the manubrium sterni and the distance between the bilateral clavicles. The safe angle and length of drilling into the mauubrium sterni for implants were determined. Results There were no significant differences between the above left and right measurements （ P 〉 0.05 ）. There were no significant differences in length between the clavicular notch and the internal extremity of clavicle on the coronal image （ P 〉 0. 05）. The anteroposterior dimension of the clavicular notch was significantly shorter than that of the internal extremity of clavicle on the cross section （ P 〈 0.05）. Of the tissues behind the sternum, the anonyma and the bilateral innominate veins were the nearest to the manubrium sterni. The safe angle and length of drilling into the manubrium sterni for implants were α 〉 46° or β 〈- 49° and 2.38± 0. 61 cm respectively. Conclusion This investigation provides specific and quantitative CT data of the sternoclavicular joint which may help clinical diagnosis and treatment of the sternoclavicular dislocation.
出处
《中华创伤骨科杂志》
CAS
CSCD
2011年第4期319-323,共5页
Chinese Journal of Orthopaedic Trauma
关键词
胸锁关节脱位
影像学
计算机断层扫描
Dislocation of the sternoclavicular joint
Imageology
Computed tomography
