肋骨肋头关节面的解剖学观测及其临床意义

Applied anatomy of joint of costal head in ribs and its clinical significance

目的观测成人肋头关节形态特征，填补国人人类学数据，并为临床诊治脊柱胸段疾患提供解剖学依据。方法观测成套肋骨标本，描述肋头关节形态学特征。结果肋头关节面48．7％为双关节面，按面积大小分型，上小下大型占41．7％，上下相等型占6．5％，上大下小型仅占0．5％；按凸凹形态分型，上平下凹型占32．1％，上下双凹型占13．9％，上凹下平型仅为2．7％。构成单关节面的肋头关节占51．3％，可分为平面型和凹面型两种，分别为平面型24．1％、凹面型27．2％。结论肋头关节面多分为单、双两种形态，其中第3～10肋双关节面出现率更高，且形态变异较大，可能是双关节面更易出现肋头关节劳损与错位的重要原因。

Objective To observe the morphological features of joints of costal head in adult and to provide anatomical references to the clinical diagnosis and treatment of thoracic spine disease. Methods Complete costal specimens were observed and morphological characteristics of joints of costal head were described. Results According to the results of observation ,48.7% of the costal head articular surface had double surfaces. Based on the classification by size, 41.7% articular surface had the superior surface smaller than the inferior surface, 6.5% had two articluar surfaces with the same area and only 0.5% had the superior surface larger than the inferior. Based on the classification by morphological pattern, 32.1% had flat superior surface and concave inferior surface, 13.9% had two concave surfaces and only 2.7% had concave superior surface and flat inferior surface. 51.3% of the costal head articular surface was single surface characterized by flat（24.1% ） and concave（27.2% ） two kinds. Conclusion The articular surface of costal head is divided into single form and double form. Double form is prone to appear in 3 to 10 costal ribs with more morphological variations; it may be an important reason for costal head strain and dislocation in double costal articular surface form