冈盂切迹的解剖形态学测量及临床意义

Anatomic measurement of the spinoglenoid notch and analysis of its clinical significance

目的探讨干燥标本的冈盂切迹解剖形态学测量及其临床意义。方法收集282例干燥肩胛骨标本,观测冈盂切迹宽度(关节盂内侧缘至肩胛冈直线距离)、冈盂切迹厚度(冈盂切迹最低点厚度)、冈盂切迹深度、冈盂切迹转折角(肩胛切迹,冈盂切迹最低点连线与肩胛冈基底部所成的夹角)等。结果冈盂切迹宽度、深度分别为(12.75±1.06)mm、(11.65±1.89)mm,且右侧更宽更深,双侧对比P<0.05有统计学差异;冈盂切迹厚度(9.93±1.57)mm,肩胛上切迹至冈盂切迹距离为(18.73±3.18)mm,且双侧对比P>0.05;冈盂切迹转折角为(40.24±8.69)°,双侧对比P<0.05有统计学差异。结论冈盂切迹的厚度、深度、宽度和转折角均是肩胛上神经卡压症的危险因素,且冈盂切迹越深,冈盂切迹转折角越小,发生肩胛上神经卡压的几率越大。本研究解剖数据可为临床在手术入路和内固定物植入位置选择等提供参考,降低术中神经损伤风险。

Objective To investigate the anatomic morphology and clinical significance of the spinoglenoid notch based on dry scapular bones.Methods In a total of 282 scapular bones(left 134,right 148),the following data were measured using Vernier caliper and Goniometer:the width of spinoglenoid notch(the distance from medial aspect of the glenoid to the scapular),the thickness of the spinoglenoid notch(the thickness of the nadir of the spinoglenoid notch),the depth of spinoglenoid notch,the angles of the spinoglenoid notch.Results The average width and depth of the spinoglenoid notch were(12.75±1.06)mm and(11.65±1.89)mm.There was statistical difference between the two sides of body(P<0.05).The average thickness of spinoglenoid notch was(9.93±1.57)mm.The distance from the spinoglenoid notch to the suprascapular notch was(18.73±3.18)mm(P>0.05).There was statistical difference of the angles of the spinoglenoid notch between the two sides of body(40.24±8.69)(P<0.05).Conclusion The width,thickness and depth of the spinoglenoid notch are all the risk factors contributing to the suprascapular nerve entrapment syndrome.The smaller the angles of the spinoglenoid notch,the greater the chance of scapular nerve compression.The data presented in this study can provide a reference for clinicians to choose the best surgical approach and the internal fixation site to reduce the risk of intraoperative nerve injury,thus minimizing intraoperative risks.