腕关节三角纤维软骨复合体解剖及组织学观察

ANATOMICAL AND HISTOLOGICAL FEATURES OF WRIST TRIANGULAR FIBROCARTILAGE COMPLEX

目的解剖、测量并描述三角纤维软骨复合体(TFCC)的尺月韧带、尺三角韧带及桡尺韧带,分析运动神经纤维在TFCC不同区域的分布。方法解剖腕关节标本后观察并测量记录TFCC相关韧带的数据、走行及位置关系。对新鲜TFCC标本进行Karnovsky-Roots染色,光学显微镜下观察染色的阳性反应区域的分布以及神经纤维走行。结果桡尺韧带在掌侧面的一端止点位于尺骨小凹处;尺骨小凹止点处的尺月韧带、尺三角韧带交叉呈“V”形,止于对应腕骨的掌侧并维持着腕骨与尺骨之间的稳定。6例染色标本光镜下观察显示:4例TFCC背侧部阳性反应区域密集分布,2例TFCC的各部位阳性反应不明显;阳性反应密集的区域在高倍光镜下可见神经纤维走行。结论尺月韧带、尺三角韧带、桡尺韧带对维持尺骨小头与腕骨之间的TFCC的稳定性起到重要作用。染色标本中可观察到着色明显的胆碱能神经,初步认为是运动神经纤维。

Objective To dissect,measure,and describe the ulnolunate ligament,ulnotriguetrum ligament,and radioulnar ligament of the triangular fibrocartilage complex(TFCC),and to investigate the distribution of motor nerve fibers in different regions of TFCC.Methods The wrist joint specimen was dissected to observe,measure,and record the data,shape,and position relationship of TFCC-related ligaments.Karnovsky-Roots staining was performed for fresh TFCC specimen to observe the distribution of positive reaction areas and nerve fibers under a microscope.Results The end point of the radioulnar ligament on the side of the palm was located at the small concave of the ulna.The ulnolunate ligament and the ulnotriguetrum ligament at the small concave of the ulna intersected with each other in a“V”shape,stopping at the palm side of the corresponding carpal bone and maintaining the stability between the carpal bone and the ulna.Six stained specimens were observed under a microscope,among which 4 had densely distributed positive reaction areas in the dorsal part and 2 had no obvious positive reaction in each part.Nerve fibers were observed in the areas with dense positive reactions under a high-power microscope.Conclusion The ulnolunate ligament,the ulnotriguetrum ligament,and the radioulnar ligament play an important role in maintaining the stability of TFCC between the ulnar head and the carpal bone.Significantly colored cholinergic nerves can be observed in the stained specimens,which are preliminarily considered to be motor nerve fibers.