手舟骨微创内固定解剖学基础

Anatomy basis for the internal fixation of wrist scaphoid with arthroscopy

目的 :为手舟骨微创条件下的内固定提供解剖学依据。方法 :86块成人干燥手舟骨 ,仔细观察其形态及主要血管压迹 ,并根据可能进行的内固定方式用游标卡尺对手舟骨的各部位进行测量 ,解剖 4例经过灌注的手标本。结果 :舟骨结节远端的厚度为 (7.4± 0 .9)mm、宽度为 (6.2± 0 .7)mm ,高度为 (10 .5± 1.4)mm ;舟骨腰部的厚度为 (12 .2± 1.3 )mm、宽度为 (9.5± 1.0 )mm ;舟骨体部的高度为 (18.0± 1.7)mm ,最小厚度为 (7.3± 0 .9)mm ;舟骨的纵轴长度为 (2 6.8± 2 .5 )mm。手舟骨的主要血管来自桡背侧部 ,由体部沿嵴部贯穿整个纵轴。结论 :手舟骨的相关参数均为设计螺钉的关键指标。关节镜监视下的手舟骨骨折内固定的进钉应从手舟骨结节的远端中点进入 ,方向平行于手舟骨的主要血管束。

Objective: To provide the anatomy basis for the infernal fixation of scaphoid with arthroscopy.Methods: The shape and blood vessel trace of 86 cases of scaphoid were observed and measured.Results: The thickness and the width of the distal portion of scaphoid node were 7.4±1.0 mm and 6.2±0.7 mm.The height of scaphoid node was 10.5±1.4 mm. The thickenss and the width of scaphoid waist were 12.2±1.3 mm and 9.5±1.0 mm.The height and the minimal thickness of the body of scaphoid were 17.9±1.7 mm and 7.3±0.8 mm.The axis length of scaphoid was 26.8±2.5 mm.The main blood vessel came from the back of radius and passed through the whole scaphoid along the crest of scaphoid.Conclusion: The related data of scaphoid are the key index of internal fixation screw designing.The screw should be entered from the middle of the distal portion of the scaphoid node and paralleled the main blood vessel of scaphoid under arthroscopy.