掌侧入路保留旋前方肌治疗桡骨远端不稳定骨折的解剖研究

An anatomy study of reserving pronator quadratus in treating unstable distal radius fractures via volar approach

目的探讨掌侧入路并保留旋前方肌的钢板内固定技术治疗桡骨远端不稳定骨折的解剖基础。方法常规尸体解剖观察旋前方肌的形态、神经血管束的走行,毗邻关系,测量肌肉相关形态学指标,以及剥离旋前方肌远端附着后桡骨远端显露范围。结果旋前方肌远侧缘与腕关节距离为(9.32±2.39)mm,经切开剥离后,该距离可增加至(23.10±2.08)mm,在旋前方肌近侧缘的平面,血管神经束距桡骨尺侧缘的距离为(5.92±0.21)mm。结论该研究证实了掌侧入路保留旋前方肌的钢板内固定术治疗桡骨远端不稳定骨折的解剖基础以及其潜在的应用意义。

Objective To explore anatomic basis of reserving pronator quadratus（PQ）in treating unstable distal radius fractures via volar approach. Methods Eighteen human cadaveric forearms were dissected to observe and measure the morphologic features around the muscle,the distribution of pronator quadratus,the course of its neurovascular bundles,and the length of the distal radius that can be exposed by mobilizing the distal edge of pronator quadratus from its radial attachment. Results Mean distance from the distal edge of PQ to wrist joint was（9.32±2.39）mm,which can be raised to（23.10±2.08）mm after PQ was mobilized. Mean distance from neurovascular bundles to ulnar side of radius at proximal edge the muscle was（5.92±0.21）mm. Conclusion The study confirms anatomical basis and potential application value of reserving pronator quadratus（PQ）in treating unstable distal radius fractures via volar approach.