阔肌代臀肌的应用解剖学及力学分析

An Applied Anatomical Study and Mechanical Analysis of the Latissimus Dorsi Muscle Transplanted for Reconstruction of the Gluteal Muscle

为配合背阔肌代臀肌治疗脊髓灰质炎后遗症这一术式的开展,在尸体材料上进行了应用解剖学研究和力学分析。以背阔肌代替瘫痪的臀肌,可使髋关节在三个运动轴上行外展、外旋和后伸运动。背阔肌的神经血管走行在肌的深面,并在肩胛骨下角下方分支进入肌内,贴附深层结构分离,可避免损伤主要神经血管。根据解剖学特点讨论了手术中应注意的问题。

The latissimus dorsi muscles with their nerves and blood vessels were investigatedon 30 sides of adult cadavers.It was found that the antero-lateral region of the mus-cle was thicker than the other regions,and its tendinous membrane could be easily se-parated from the thoracolumbar fascia.The thoraco-dorsal nerve was accompanied bythe thoracodorsal artery which derided into three branches at the point about 3.5cmbelow the inferior angle of scapula,An imitative study demonstrated that the transfer of the muscle for the reconstruction of gluteal muscle could make the lower extremityabduct, lateral-rotate and posterior-extend.This suggests that it might be useful totransfer the antero-lateral region of the latissimus dorsi muscle for the reconstructionof the gluteal muscle.When this operation is performed,the incision should be locatedbelow the level of the inferior angle of scapula to avoid injuring the nerves and ves-sols.