微创内固定技术治疗锁骨骨折的基础研究

The treatment of clavicle fracture adopting minimally invasive technique:anatomic study

目的:根据锁骨形态特点,探讨微创内固定技术治疗锁骨骨折的手术入路。方法:成人锁骨标本60个,防腐成人尸体(8具)的肩关节标本16个。测量锁骨长度、锁骨最窄处直径、锥状结节处入钉点区域及该部位入钉在锁骨内的固定长度。结果:锁骨长度为(144.34±6.48)mm;最窄处直径为(9.40±1.92)mm。锁骨锥状结节至肩锁关节内侧进针范围为(32.86±5.18)mm;该范围内最近及最外穿刺点打入的克氏针均可通过锁骨前弧最凸点,穿行长度最短为(74.28±1.16)mm,最长为(98.86±2.16)mm。肩关节标本解剖显示,锁骨外侧端与肩胛冈形成向内侧开放的角度,锥状结节以远部分比相应的肩胛冈高(8.24±0.62)mm。左、右侧锁骨测量结果经t检验两侧无显著性差异(P>0.05)。结论:锁骨锥状结节处可作为微创手术入路及入钉点区域,该部位入钉可在锁骨内穿行足够的固定长度。

Objective： To explore the possibility of minimal invasive technique treating clavicle fracture according to anatomic characteristics of the clavicle. Methods： 60 dried clavicles and 16 antiseptic specimens of shoulder joint were used. The length of clavicle, minimal diameter, the area of entry pin at conoid tubercle and the pin length within clavicle were measured, Results： The length of clavicle was about （144.34±6.48） ram, and the minimal diameter （9.40±1.92） mm. The range of entry pin at conoid tubercle was about （32.86±5.18） mm. From this entry pin area, all pin can through the apex of clavicle arch. The shortest length of pin within clavicle was about （74.28± 1.16） mm, and the longest （98.86±2.16） mm. The dissection of shoulder joint showed that the clavicle formed an angle with the mesoscapula, and the clavicle was higher about （8.24±0.62） mm than the mesoscapula. There was no significant difference between left and right patella. Conoluaions： For minimal invasive operation, the conoid tubercle of the clavicle is a suitable area for pin entrying, through it, the enough length of pin can be obtained.