四边孔综合征的解剖学基础

<title>atomical Basis of the Quadrilateral Foramen Syndrome

目的:为四边孔综合征的病因和诊治提供解剖学基础。方法:解剖观察成尸胸上肢标本36(男30、女6)侧四边孔的组成、内容及毗邻关系,并摹拟观察四边孔综合征的成因。结果:①四边孔上下径(18.4±1.9)mm,左右径(18.6±4.3)mm;②腋神经外径为(4.3±1.2)mm,腋动脉外径为(3.0±0.9)mm,腋静脉外径为(2.1±0.9)mm;③腋神经位于四边孔内上壁处,肩关节外展90°或过度活动时,腋神经被绷紧在肩胛下肌腱、肱骨外科颈和肩关节囊之间。结论:肩关节持续的过度屈、伸、展及四边孔长期受压和周围骨骼肌病变,是挤压腋神经引发四边孔综合征的解剖学基础。

<abstract>jective: To provide anatomical data for the pathogeny, and the dignosis and treatment of the quadrilateral foramen syndrome. Methods: The content of the quadrilateral foramen, its shape and their relations were observed on 36 sides (male 30 sides, formale 6 sides) of the upper limb of adlut cadavers. The cause of the quadrilateral foramen syndrome was mimicked. Results :①The vertical diameter of the quadrilateral foramen was (18.4±1.9) mm and the transverse diameter was (18.6±4.3) mm. ②The outer diameter of the axillary nerve was (4.3±1.2) mm. The outer diameter of the axillary artery was ( 3.0±0.9 ) mm. The outer diameter of the axillary yein was (2.1±0.9)mm. ③The axillary nerve was located in the internal superior wall of the quadrilateral foramen. When the shoulder joint was in 90 degree of outer abduction and in a standing excess activity, the axillary nerve was tightened and located among the subscapular muscle tendon, the humerus surgical neck and the shoulder joint capsule. Conclusion: A standing excess of flexion, extension, adduction, abduction of the shoulder joint and the skelecton muscle with the pathological changes near the humerus could extrude the axillary nerve, which is the anatomical basis of the quadrilateral foramen syndrome.