改良式张力带法胸锁关节固定术的解剖与临床应用

Applied anatomy of tension strip fixation for sternoclavicular joint

目的探讨胸锁关节的结构特点,用改良式张力带法海设计胸锁关节复位的固定术式,为临床应用提供解剖学依据。方法在30例男性成尸标本上进行解剖观测,测量了胸锁关节胸骨及锁骨关节面的前后径、左右径,并模拟手术设计,确定穿针点,测量了钢针与经穿针点的矢状轴之间的夹角。结果观测了胸锁关节的结构特点:胸锁关节胸骨关节面前后径、左右径分别为16.7±1.3mm,23.3±2.4mm,锁骨关节面前后径、左右径分别为22.3±2.1mm、23.7±2.6mm;两根钢针与经穿针点的矢状轴之间的夹角分别为69.7°±9.8°,75.7°±8.2°。结论胸锁关节的结构特点决定了其脱位以前脱位多见且脱位后不易保持复位。采用张力带钢丝法固定复位后的胸锁关节是一种简单可靠且有效的手术方法。

Objective To provide anatomy basis for the fixation of sternoclavicular joint with the improved tension strip. Methods The steel needle entry point angle and sternoclavicular articular surface were measured on 15 cases(30 sides)of adult cadaver specimens. Mimic operation was conducted on these speciments. Results The sternal articular surface was 16.7±1.3mm long and 23.3±2.4mm wide; the clavicular articular surface was 22.3±2.1mm long and 23.7±2.6mm wide. The two angle between the steel needle and sagittal axle were 69.7°±9.8°, 75.7°±8.2°.Conclusions The front-dislocation of sternoclavicular joint is more common and is not easy to be kept replacing. To adopt improving tension strip to fix sternoclavicular replaced is a simple effective and reliable method.;