肱骨髓腔的形态学参数测量及临床意义

Morphological measurement and clinical significance of intramedullary cavity of humerus

目的 :为髓内钉的研制提供解剖学依据。方法 :分别以防腐湿肱骨 ,新鲜肱骨和干肱骨为材料 ,用牙托树脂灌铸成型后测量其内径 ;用螺旋CT测量活体肱骨髓腔内径 ,所有数据进行统计处理 ,观察各组数据的相关性关系。结果 :肱骨髓腔在中上 2 /3接近不规则圆柱体 ,自中下 1/3开始在矢状面上有一向前为 (8.8± 0 .3 )°的弧度。在桡神经沟部位的单侧骨密质最厚 (6.0± 1.5 )mm。髓腔最狭窄的部位在肱骨中下 1/3左右 ,其冠状径、矢状径在 7～ 8mm左右。分组统计结果证明 ,防腐湿肱骨的形态与新鲜肱骨无差别 ,干肱骨的形态与其他组差别显著 ,CT实测结果在大部分平面上与防腐湿肱骨及新鲜肱骨的结果无显著差别 ,与干肱骨组差别显著。结论 :肱骨髓内形状大体上接近于不规则圆柱体。

Objective: To measure parameters of intramedullary cavities of humerus castings and provide the data for developing the inter-locking nail. Methods: Four groups were adopted in the experiment. The parameters of intramedullary cavities of wet bone, fresh bone and dry bone casted by activated dental resin were measured. Meanwhile, the parameters of humerus intramedullary cavity of the volunteers were measured by helix CT. All of the data were analysed by SPSS for comparing the relationships among the four groups. Results: It was nearly an irregular cylinder at the upper 2/3 of humeral medullar, and presented a forth angle with 8.82±0.27 degree under 1/3 of the humeral medullar in sagittal plane. The thickest compact part of humerus lied in the groove for radial nerve, near to 6 mm in average. The most narrow part of the intramedullary cavity was located in the under 1/3 of humerus, and its diameter was from 7 to 8 mm in the sagittal and coronal plane. It had been proved by statistic data that there was no difference between the wet bone and fresh bone group, but the difference was remarkable between the dry bone and other group. The data of CT group was near to the wet bone and fresh bone group , and more different than the dry bone. Conclusion: the morphologic shape of humerus is similar to an irregular cylinder. The wet bone is an ideal material for the intramedullary morphologic study.