桡骨茎突部软组织结构的解剖学观测及临床意义

Anatomy study of soft tissue in the styloid process of radius and its clinical significance

目的观测桡骨茎突部软组织结构的特点及变异,为临床局部封闭、针刀等治疗提供解剖学依据。方法对30例成人腕关节防腐固定标本的第1骨性纤维鞘管长度、上下口直径,及其与桡动脉、桡神经浅支间的宽度进行测量,并对纤维间隔和拇长展肌副腱进行了观测。结果单隔间63.3%(19例),表现为拇长展肌(APL)肌腱与拇短伸肌(EPB)肌腱通过同一个纤维鞘管,中间无纤维间隔;双隔间36.7%(11例),表现为纤维鞘管中存在纤维间隔将APL与EPB肌腱隔开。APL副腱70%(21例),表现为APL存在1～4条副腱。纤维鞘管的长度、下口内、外径及上口内、外径分别为(35.35±3.04)mm(、9.36±0.38)mm(、11.08±0.36)mm、(13.15±0.87)mm和(13.67±0.82)mm。纤维鞘管与桡动脉、桡神经浅支间的距离分别为(1.60±0.17)～(4.58±0.45)mm(、1.42±0.18)～(4.59±0.45)mm。结论第1骨性纤维鞘管可作为安全和有效的治疗部位。

Objective To provide anatomical data for local blocking treatment and the needle knife therapy through investigating features and anatomical variance of the soft tissue in the styloid process of radius. Methods Anatomical observation was performed at 30 adult wrist joints of cadaver samples. The diameter of upper and lower openings and length of the first extensor compartment, the distance from the first extensor compartment to radial artery and the distance from the first extensor compartment to superficial branch of radial nerve were measured. The septa of the extensor compartments and APL tendons were observed, Results In 19 specimens （63.3%）, there was two tendons （APL and EPB） in one compartment. In 11 specimens （36.7%）, there was APL and EPB in two separate compartments. In 21 specimens （70%） , APL had more than one tendon. The length, inside and outside diameters of lower opening and inside and outside diameters of upper opening of the first extensor compartment were （35.35±3.04） mm, （9.36±0.38） mm, （11.08±0.36） mm, （13.15± 0.87） mm and （13.67±0.82） mm. The distance from the first extensor compartment to radial artery and the distance were （1.60±0.17）-（4.58±0.45） mm, （1.42±0.18 ）-（4.59±0.45） mm from the first extensor compartment to superficial branch of radial nerve. Conclusion The first extensor compartment is a safe and effective area for treatment.