肱骨远端髓腔内骨嵴的形态特点及其临床意义

Morphology and clinical significance of the distal intramedullary bony crista of the humerus

目的:探讨肱骨远端髓腔内骨性突起形态学特征及其潜在的临床意义。方法:应用16层CT对80根肱骨远段1/3进行扫描,三维重建成像后,从冠状面、矢状面和横截面观察并描述鹰嘴窝上髓腔内骨性突起的形态特点,然后将20根肱骨远段1/3在冠状面上从中线纵行剖开,对髓腔内骨嵴行直观的观察。结果:鹰嘴窝上髓腔内1.9～3.2cm(平均2.6cm)范围内存在骨性突起,骨质与皮质骨相近,基底部位于后方,内、外侧分别呈倒八字形排列,骨嵴以一侧为主,其中59根以内侧为主,21根以外侧为主,呈2～3行平行排列,另一侧骨嵴则较紊乱。结论:本文描述了以前未有记载的肱骨远端髓腔内骨嵴的形态,对肱骨远端骨折内固定和肘关节人工关节置换都有一定的临床意义。

Objective： To study the morphology of the distal intramedullary bony crista of the humerus, and reveal its potential clinical significance. Methods： The distal 1/3 of eighty humeri was scanned by 16 layer spiral CT. The morphologic features of the intramedullary bony prominence above the olecranon fossa were observed and described on coronal, sagittal and transverse section after three-dimensional reconstruction. Then the distal 1/3 of twenty humeri was splitted vertically along the coronal midline for observing the intramedullary bony crista. Results： Intramedullary bony crista could be found from 1.9 to 3.2 cm （mean 2.6 cm） above the olecranon fossa. The component of the bony crista was similar to that of cortical bone. The posterior part was the basilar part of bony crista, which ranged intero-inferiody along the medial and lateral side. It was obvious only at one side with the shape of 2-3 parallel crista （59 of medial type and 21 of lateral type）. Conclusions： The study describes the morphologic features of the distal intramedullary bony crista of the humerus that have never been recorded. The results are valuable for internal fixation of the distal humerus fracture and elbow arthroplasty.