肱三头肌长头重建肩外展功能的应用解剖

The applied anatomy of the reconstruction of shoulder with long head of triceps muscle

目的 :研究肱三头肌长头血管神经蒂特点为以其重建肩外展功能提供解剖学基础。方法 :对44侧固定尸体的肱三头肌长头肌肉起点及血管神经蒂进行解剖与测量。结果 :肱三头肌长头起点背侧为肌性 ,腹侧为腱性 ,腱性起点长度 (9.9± 1.5 )cm ,宽度 (2 .4± 0 .4)cm。神经支配来自桡神经的分支 ,可分离长度 (6 .8± 2 .7)cm ,直径 (2 .0± 0 .4)mm。血供来自 :①肱动脉肱三头肌支 ,长度 (3 .4± 1.4)cm ,外径(2 .0± 0 .3)mm ;②肱深动脉的分支 ,长度 (2 .5± 0 .9)cm ,外径为 (1.6± 0 .5 )mm ,分离至肱动脉长度为 (3 .9± 1.3)cm。血管神经蒂以多级分支为主。结论 :依据肱三头肌长头及其血管神经蒂的特点 ,可作为肩外展功能重建术中的动力肌。

Objective:To study the morphological characters of long head of triceps muscle and its pedicel of vessel and nerve.Methods:44 upper extremities of fixed human cadavers were dissected.The origins of long head of triceps muscle were measured.The pedicels of vessels and nerves were measured also.Results:Dorsal origins were muscular,ventral origins were tendinous,length of tendinous part was 9.9±1.5 cm,width was 2.4±0.4 cm.The long head of triceps muscle was innervated by radial nerve.The nerve was accompanied with the vessel and also had multiple grade branches.The length of nerve was 6.8±2.7 cm,the diameter was 2.0±0.4 mm.One part of the blood supply of long head of triceps muscle was from humeral artery(43.2%),length was 3.4±1.4 cm,diamter was 2.0±0.3 mm;the other was from humeral profundus artery (45.5%),length was 2.5±0.9 cm,diameter was 1.6±0.5 mm.And if the vessel was separated to the humeral artery,its length was 3.9±1.3 cm.The pedicel of nerve and vessel had multiple grade branches.Conclusion:According to the characters of long head of triceps muscle and pedicel of vessel and nerve,the muscle was suitable for reconstruction surgery of shoulder.