结节间沟及其毗邻结构断层解剖学研究

Cross-section anatomy of the bicipital groove and its adjacent structures

目的本文旨在研究肱二头肌长头脱位的机制以及相关手术方法提供结节间沟和其毗邻结构的解剖学基础。方法成人尸体肩关节部标本3例,制成1.0～1.5 mm厚的水平位、矢状位、冠状位火棉胶连续切片。结果①肩胛下肌肌腱发出之后沿肩关节囊前方走行,在小结节前侧,与关节囊紧密结合,横过结节间沟,扩展到大结节外侧面与冈上肌肌腱指点相融合。②肱二头肌长头通过结节间沟部分表面由肌腱腱鞘所包绕。③结节间沟出口平面,喙肱韧带内侧分支和盂肱上韧带形成复合体结构,加强肱二头肌长头内侧。结论①肩胛下肌肌腱不止于小结节,而是越过结节间沟表面和冈上肌肌腱止点融合;②喙肱韧带和盂肱上韧带是防止肱二头肌长头脱位的重要的结构之一;③手术治疗此种损伤造成的肱二头肌长头脱位应重建其解剖学结构,以防止再脱位的发生。

Objective To provide anatomy data to the bicipital groove and its adjacent structures for the study of the dislocation of long head of biceps tendon and relative surgerial method.Methods Three shoulder specimens were embedded by celloidin and made into successive horizontal,coronal,sagittal slices with the thickness of 1.0-1.5 mm.Results ① The tendon of supscapularis courses along the anterior side of capsule of shoulder joint.The tendon did not terminate into the lesser turbercle,and pass over the bicipital groove.② The surface of the long head of biceps tendon was encircled by the tendon sheath.③ In the level of the entrance of bicipital groove,the coracohumeral ligament and superior glenohumeral ligament formed a complex and reinforce medially the long head of biceps tendon.Conclusions ① The tendon of supscapularis do not terminate onto the lesser turbercle,pass over the bicipital groove and blend with the insertion of supraspinaris tendon.② The the coracohumeral ligament and superior glenohumeral ligament are key structures to prevent the long head of biceps tendon from dislocation.③ It is necessary to reconstruct the anatomical structures when disposing the dislocation caused by the lesions.