“三线定位法”体表定位诊断旋后肌综合征的研究

“Three-line localization method”body surface localization in the diagnosis of supinator syndrome

目的应用“三线定位法”对桡神经深支穿入及穿出旋后肌的位置进行定位,探讨其对于旋后肌综合征的诊断意义。方法对10具成人尸体肘前臂标本的旋后肌桡神经深支进行层次解剖。分别以肱骨外上髁、尺骨鹰嘴、桡骨茎突Lister结节三点作为三角形顶点,三线定位标记出三角形,测量桡神经深支穿入旋后肌与穿出旋后肌的位点,测量位点距离三角形三条边长的距离。结果前臂Frohse弓腱性组织结构14肢,占70%,混合性组织结构4肢,占20%,膜性组织结构2肢,占10%;前臂旋后肌下缘腱性组织结构11肢,占55%,肌性组织结构5肢,占25%,混合性组织结构3肢,占15%,膜性组织结构1肢,占5%。女性L4/L2数值约为0.07,L4/L5数值约为1.02,L6/L2数值约为0.26,L7/L6数值约为0.16;男性L4/L2数值约为0.07,L4/L5数值约为1.10,L6/L2数值约为0.25,L7/L6数值约为0.17。应用“三线定位法”测量发现,前臂取中立位、曲肘90°,桡神经深支进入Frohse弓的位点位于肱骨外上髁远端1横指(1寸)、桡掌侧1横指(1寸)的位置,桡神经深支穿出旋后肌下缘的位点位于肱骨外上髁远端4横指(3寸)、桡背侧半横指(0.5寸)的位置,简易定位法适用于男、女性,且左右两侧均可。结论桡神经深支进入Frohse弓的位点以及桡神经深支穿出旋后肌下缘的位点可以应用拇指同身寸法进行简易定位,应用“三线定位法”可以对旋后肌综合征进行快速诊断。

Objective The“three-line localization method”was used to locate the position of the deep branch of the radial nerve penetrating into and out of the supinator muscle,and to explore the diagnostic significance of“three-line localization method”for supinator syndrome.Methods The deep branch of the radial nerve of the supinator muscle in the elbow forearm specimens of 10 adult cadavers were dissected.The three points of the external epicondyle of humerus,the olecranon of ulna and the Lister nodule of radial styloid were taken as vertices of the triangle,and the triangle was marked by three-line localization.The sites of the deep branch of the radial nerve penetrating into and out of the supinator muscle were measured,and the distance from the sites to the three sides of the triangle was measured.Results There were 14 limbs of tendinous tissue structure of the forearm Frohse arch,accounting for 70%,4 limbs of mixed tissue structure,accounting for 20%,and 2 limbs of membranous tissue structure,accounting for 10%.There were 11 limbs of tendinous tissue structure of the lower margin of the supinator muscle of the forearm,accounting for 55%,5 limbs of muscular tissue structure,accounting for 25%,3 limbs of mixed tissue structure,accounting for 15%,and 1 limb of membranous tissue structure,accounting for 5%.For women,the L4/L2 value is about 0.07,the L4/L5 value is about 1.02,the L6/L2 value is about 0.26,and the L7/L6 value is about 0.16.For men,the L4/L2 value is about 0.07,the L4/L5 value is about 1.10,the L6/L2 value is about 0.25,and the L7/L6 value is about 0.17.Using the“three-line localization method”,it was found that the forearm was in the neutral position,the elbow was flexed by 90°,the site where the deep branch of the radial nerve penetrated into the Frohse arch was located at 1 transverse finger(1 inch)on the distal external epicondyle of humerus and 1 transverse finger(1 inch)on the radial palmar side,the site where the deep branch of the radial nerve penetrated out of the lower margin of the supinator muscle was located at 4 transverse fingers(3 inches)on the distal external epicondyle of humerus and the half transverse finger(0.5 inch)on the radial dorsal side.The simple localization method was applicable to men and women,and both sides can be used.Conclusion The site where the deep branch of the radial nerve penetrates into the Frohse arch and the site where the deep branch of the radial nerve penetrates out of the lower margin of the supinator muscle can be easily located by the thumb body inch method,and the“three-line localization method”can be used for the rapid diagnosis of the supinator syndrome.