尺侧腕屈肌的应用解剖及临床意义

Applied Anatomy of Flexor Carpi Ulnaris

目的 :查清尺侧腕屈肌尺侧半和桡侧半的肌内神经分支分布情况及肌构筑情况 ,揭示该肌的形态学特征 ,为临床矫形外科“半肌”移位手术提供形态学依据 ,并为自体骨骼肌移位的选材提供新思路。方法 :①观察 2 0侧尺侧腕屈肌大体形态 ,并测量有关数量 ;②用改良Sihler’s染色法对 10侧尺侧腕屈肌进行肌内神经染色 ,以观察肌内神经的分支分布 ;③取 2 0侧尺侧腕屈肌沿肌内腱长轴分为尺侧半和桡侧半 ,并测量其构筑学数值。结果 :①尺神经干发出 2支神经分别进入尺侧腕屈肌尺侧半和桡侧半 ,并在相应的半侧肌内各自发出数级神经分支 ,各级神经分支间有丰富的吻合 ;但尺、桡侧半的肌内各级神经支在肌内腱板区域无吻合。②尺侧腕屈肌尺侧半的肌长、肌重、羽状角、及生理横切面积数值均较桡侧半大 ,而肌纤维长的数值则较桡侧半小。结论 :①尺侧腕屈肌可分为尺侧亚部和桡侧亚部 ,两亚部各有一独立神经支配 ;②尺侧腕屈肌尺侧亚部和桡侧亚部都是半羽肌 ,尺侧亚部能产生多于桡侧亚部

Objective:To reveal morphologic features of human flexor carpi ulnaris(FCU) for clinical application by investigating intramuscular nerve branches distribution and muscle architectural features of ulnaris compartment and radial compartment.Methods:(1)Macroscopical dissection was used to observe the pattern on the whole and to measure the relevant data of 10 cadavers;(2)Sihler’s neural staining technique was used to observe the nerve branches distribution of 5 cadavers;(3)Ulnar compartment and radial compartment of human FCU of 10 cadvers were used to study the muscle architectural features.Results:(1)Two nerve branches from the ulnar nerve get into ulnar compartment and radial compartment respectively.Not only did the nerves of ulnar compartment and radial compartment deliver many branches to respective regions,but also these branches had plentiful joints.But between the nerve of ulnar compartment and that of radial compartment no joint occurred in the area of instramuscular tendon.(2)The muscle length,muscle weight,pinnate angle and cross sectional area of ulnar compartment of FCU were bigger than those the radial compartment,but architecture features of the muscle fiber length smaller than those of the radial compartment.Conclusion:(1)The flexor carpi ulnaris can be divided into ulnar compartment and radial compartment and they have their own nerve.(2)Ulnar compartment and radial compartment are half pinnate muscle and the force produced by ulnar compartment is 1 times more than that by radial compartment.