尺骨滋养血供与肌附着的观测及其临床意义

The observation of the nutrient blood supply and the attachment of muscle on ulna and its clinical significance

目的确定尺骨滋养孔和肌附着的自身百分位置以及滋养动脉与肌附着的关系。方法对成人76块游离尺骨的滋养孔进行观测,解剖20具成年尸体尺骨上的肌附着并定位其百分位置,观察滋养动脉起始与走形。结果尺骨滋养动脉多来自尺动脉,其滋养孔主要位于尺骨掌面指深屈肌附着的近、中1/3交界处,距离尺骨鹰嘴上缘(9.06±1.26)cm,占尺骨长的(37.41±5.17)%。从肱骨内上髁至远侧,尺骨近端的肱肌、掌面的指深屈肌和旋前方肌的肌附着近侧点和远侧点分别位于前臂尺侧长的(14.36±1.94)%和(22.60±2.01)%、(16.91±3.98)%和(74.60±3.62)%、(76.23±3.51)%和(94.41±2.57)%处。从尺骨鹰嘴上缘至远侧,尺骨内侧面的指深屈肌、背面的肘肌、拇长展肌、拇长伸肌和示指伸肌的肌附着近侧点和远侧点分别位于尺骨长的(9.22±2.78)%和(71.50±5.01)%、(7.89±1.07)%和(33.63±3.38)%、(34.77±6.47)%和(65.91±9.69)%、(38.75±4.42)%和(72.30±4.05)%、(56.76±5.49)%和(82.73±4.43)%处。结论这些结果对尺骨骨折手术入路和治疗决策的选择具有一定参考价值。

Objective To locate the percent position of the nutrient foramen and the attachment of muscle （AM） on ulna and observe the interrelation between the nutrient artery and the AM on ulna. Methods The nutrient fo- ramina of ulna were located in 76 adult ulna. The AM on ulna was located and the nutrient artery of ulna was ob- served in 20 adult cadavers. Results The nutrient artery of ulna mainly came from the ulnar artery. The nutrient foramina of ulna were mainly situated at the junction of the proximal 1/3 and distal 2/3 of the AM of flexor digi- torum profundus on ulnar palmar surface with the distance of （9.06 ± 1.26 ） cm from the olecroanon of ulna. The percentage of the distance in the length of ulna was （37.41 ±5. 17） %. In the AM of the brachialis on the proximal end of ulna, and the flexor disitorum profundus and the pronator quadratus on the palmar surface of ul- na, the percentage of the distance from their proximal point and distal point to medial epicondyle of humerus in the ulnar length of forearm were （ 14.36±1.94） % and （22.60 ± 2.01 ） %, （ 16.91 ± 3.98） % and （74. 60 ± 3.62） %, （76.23 ± 3.51 ） % and （94.41 ± 2. 57） % , respectively. In the AM of the flexor disitorum pro- fundus on the medial surface of ulna, and the anconeus, the abductor pollicis longus, the extensor pollicis longus and the extensor indicis on the dorsal surface of ulna, the percentage of the distance from their proximal point and distal point to the superior border of olecroanon of ulna in the length of ulna were （9. 22 ±2. 78） % and （71.50 ± 5.01） %, （7.89±1.07） % and （33.63 ±3.38） %, （34.77 ±6.47） % and（ 65.91 ±9.69） %, （38.75± 4. 42） % and （72. 30 ±4. 05） %, （56. 76 ±5.49） % and （82. 73 ±4. 43） % , respectively. Conclusion These results can provide valuable information for surgical approaches and therapeutic strategies of ulnr fracture.