肩关节手术外侧入路与解剖

Lateral Approach to the Shoulder Joint and Anatomy

目的:为肩关节手术外侧入路和避免损伤腋神经提供解剖学依据。方法:对60侧成尸上肢标本,按照手术进路和层次进行解剖观测。结果:(1)三角肌起点弧长22.6±4.0cm,中线长15.3±2.3cm;(2)腋神经前支长2.9±0.7cm,分支主要支配三角肌前部和外侧部;(3)腋神经前支与肩峰至三角肌粗隆连线相交点,位于肩峰平面下方6.2±1.3cm,此段距离相当于三角肌上2/5份。结论:手术切口和分离三角肌纤维的远侧点均不应超过三角肌中线长的上2/5份,否则容易损伤腋神经前支。

Objective: In order to provide anatomical proof for lateral approach to the shoulder joint and avoid to damage to the axillary nerve. Methods; Anatomical observation as been made on 30 adult cadavers (60 upper limbs) on the basis of operational approach and layer.Results: 1 .The starting curve length of the deltoid muscle is 33.6 ++++++++++ 4. 3cm, The middle part lengty is 15.3 ++++++++++ 2.3cm 2. The anterion branch lengty of axillary nerve which controls the anterior part of the dieltoid muscle and the lateral part is 2.9 ++++++++++ 0.7cm 3.The point at which the anterior branch crosses the acromialos to the tuberosity deltoid muscle lies under the acroimalos plane 6.2 ++++++++++ 1. 3cm and the distance is equal to the 2/5 of the deltoid muscle' s length. Conclusions: the operative incison and the farthest separation of the deltoid muscle. fiber can' t go be yound the upper 2/5 of the middle part length in order not to harm the anterion beanch of axillary