基于新鲜标本喙锁韧带的解剖学形态测量及临床意义

张磊; 唐小高; 金玉峰; 张华强; 周鑫; 喻林; 汪国友; 扶世杰

doi:10.16098/j.issn.0529-1356.2021.06.019

PDF(2142 KB)

解剖学报 ›› 2021, Vol. 52 ›› Issue (6) : 954-959. DOI: 10.16098/j.issn.0529-1356.2021.06.019

解剖学

基于新鲜标本喙锁韧带的解剖学形态测量及临床意义

张磊^1,2,3,4 唐小高¹ 金玉峰⁵ 张华强⁵ 周鑫^1,2,3,4喻林^1,2,3,4 汪国友^1,2,3,4 扶世杰^1,2,3,4*

作者信息 +

Anatomical morphometry of coracoclavicular ligament based on fresh cadaver and clinical significance

ZHANG Lei^1,2,3,4 TANG Xiao-gao¹ JIN Yu-feng⁵ Zhang Hua-qiang⁵ ZHOU Xin^1,2,3,4 YU Lin^1,2,3,4 WANG Guo-you^1,2,3,4 FU Shi-jie^1,2,3,4*

Author information +

文章历史 +

摘要

目的基于新鲜尸体标本对喙锁韧带进行解剖学测量，为临床中喙锁韧带解剖重建提供解剖学依据。方法选取52例肩锁关节标本(新鲜尸体)，通过对肩锁关节标本进行解剖，观察喙锁韧带结构的解剖特点，分别测量锥状韧带的最大长度(QR)、斜方韧带的最大长度(ST)、锥状韧带喙突止点到喙突尖的距离(RV)、斜方韧带喙突止点到喙突尖的距离(TV)、锥状韧带锁骨止点到肩锁关节的距离(QU)、斜方韧带锁骨止点到肩锁关节的距离(SU)、锁骨上平面到喙突下平面的距离(WX)，并计算斜方韧带锁骨止点的平均直径(a-)、锥状韧带锁骨止点的平均直径(b-)、斜方韧带喙突止点的平均直径(c-)以及锥状韧带喙突止点的平均直径(d-)等数据，并对测量结果进行统计学分析。结果左侧和右侧斜方韧带锁骨止点的最小直径、斜方韧带喙突止点的最小直径在左右间差异无统计学意义(P>0.05)；喙锁韧带的喙突与锁骨止点的最大直径与最小直径在男女间差异无统计学意义(P>0.05)；左侧和右侧锥状韧带的最大长度(14.19±2.43、15.87±2.99)mm，锥状韧带喙突止点到喙突尖的距离(36.66±4.25、33.61±3.45)mm，锥状韧带锁骨止点的平均直径(11.95±1.43、11.23±1.12)mm和锥状韧带喙突止点的平均直径(9.20±1.60、7.90±0.76)mm间差异具有统计学意义(P<0.05)，而喙锁韧带的其他解剖形态在左右间差异无统计学意义(P>0.05)；喙锁韧带的解剖形态在男女间差异无统计学意义(P>0.05)。结论本研究对喙锁韧带相关解剖学形态进行了全面的测量，为涉及喙锁韧带损伤的肩锁关节疾病提供了相关解剖学数据，有利于术者在肩锁关节脱位手术中尽可能地完成喙锁韧带的解剖学重建。

Abstract

Objective To measure the anatomical morphology of coracoclavicular ligament based on fresh cadavers, and to provide anatomical basis for anatomical reconstruction of coracoclavicular ligament. Methods A total of 52 the acromioclavicular joints(fresh body specimen) was dissected, and the anatomical characteristics of coracoclavicular ligament were observed by dissecting acromioclavicular joint specimens. The anatomic data of which the length of the conoid ligament(QR), the length of the trapezoid ligament(ST); the distance from the conoid ligament attachment on coracoid to coracoid tip(RV), the distance from the trapezoid ligament attachment on coracoid to coracoid tip(TV), the distance form conoid ligament attachment on the clavicular to acromioclavicular joint(QU), the distance form the trapezoid ligament attachment on the clavicular to acromioclavicular joint(SU), the distance from supraclavicular plane to subcoracoid plane(WX) were measured; and the mean diameter of the trapezoid ligament attachment on the clavicular(a-), the mean diameter of the conoid ligament attachment on the clavicular(b-), the mean diameter of the trapezoid ligament attachment on the coracoid(c-), the mean diameter of he conoid ligament attachment on the coracoid(d-) were calculation. The measurement result underwent statistical analysis. Results The minimum diameter of the trapezoid ligament attachment on the clavicular and coracoid on the left and right sides, respectively. There were no significant differences in those anatomical morphology of the coracoclavicular ligament(P>0.05). The anatomical morphology of the diameter of coracoclavicular ligament attachment on the male and female had no significant difference (P>0.05). The maximum length of the conoid ligament was (14.19±2.43/15.87±2.99) mm on the left and right sides, respectively. The distance from the conoid ligament attachment on coracoid to coracoid tip was (36.66±4.25/33.61±3.45) mm on the left and right sides, respectively. The mean diameter of the conoid ligament attachment on the clavicular and coracoid was (11.95±1.43/11.23±1.12)mm and (9.20±1.60/7.90±0.76)mm on the left and right sides, respectively. There were significant differences in those anatomical morphology of the coracoclavicular ligament(P<0.05), while the others were no significant differences (P>0.05). The anatomical morphology of the coracoclavicular ligament on the male and female had no significant difference (P>0.05). Conclusion The comprehensive measurement of anatomical morphology of coracoclavicular ligament can provide an anatomical basis for shoulder joint diseases related to coracoclavicular ligament injury. It will help surgical staff perform a complete anatomic reconstruction of coracoclavicular ligaments for the surgical treatment of dislocation of the acromioclavicular joint.

导出引用

张磊唐小高金玉峰张华强周鑫喻林汪国友扶世杰. 基于新鲜标本喙锁韧带的解剖学形态测量及临床意义[J]. 解剖学报. 2021, 52(6): 954-959 https://doi.org/10.16098/j.issn.0529-1356.2021.06.019

ZHANG Lei TANG Xiao-gao JIN Yu-feng Zhang Hua-qiang ZHOU Xin YU Lin WANG Guo-you FU Shi-jie. Anatomical morphometry of coracoclavicular ligament based on fresh cadaver and clinical significance[J]. Acta Anatomica Sinica. 2021, 52(6): 954-959 https://doi.org/10.16098/j.issn.0529-1356.2021.06.019

中图分类号： R323.7+1

参考文献

［1］ van Bergen CJA, van Bemmel AF, Alta TDW, et al. New insights in the treatment of acromioclavicular separation［J］. World J Orthop, 2017, 8(12): 861-873.

［2］ Triantafyllopoulos IK, LampropoulouAdamidou K, Schizas NP, et al. Surgical treatment of acute type V acromioclavicular joint dislocations in professional athletes: an anatomic ligament reconstruction with synthetic implant augmentation［J］. J Shoulder Elbow Surg, 2017, 26(12): e369-e375.

［3］ Zhu NF, Rui BY, Zhang YL, et al. Anatomic study of coracoclavicular ligaments for reconstruction of acromioclavicular joint dislocations［J］. J Orthop Sci, 2016, 21(6): 749-752.

［4］ Debski RE, Parsons IM, Woo LY, et al. Effect of capsular injury on acromioclavicular joint mechanics［J］. J Bone Joint Surg Am, 2001, 83(9): 1344-1351.

［5］ Frank RM, Trenhaile SW. Arthroscopicassisted acromioclavicular joint reconstruction using the tightrope device with allograft augmentation: surgical technique［J］. Arthrosc Tech, 2015, 4(4): e293-297.

［6］ Struhl S. Double Endobutton Technique for repair of complete acromioclavicular joint dislocations［J］. Tech Shoulder Elbow Surg, 2007, 8(4): 175-179.

［7］ Xue C, Song LJ, Zhang M, et al. Coracoclavicular ligament attachment regions of the Chinese population: a quantitative anatomic study［J］. Anat Sci Int, 2013, 88(4): 189-194.

［8］ Rios CG, Arciero RA, Mazzocca AD. Anatomy of the clavicle and coracoid process for reconstruction of the coracoclavicular ligaments［J］. Am J Sports Med, 2007, 35(5): 811-817.

［9］ Zhang L, Chen HSh, Qi J, et al. Anatomical morphometry of the coracoid process and its clinical significance［J］. Chinese Journal of Clinical Anatomy, 2018, 36(6): 10-14.（in Chinese）

张磊, 陈亨树, 祁冀, 等. 喙突的解剖形态学测量及其临床意义［J］. 中国临床解剖学杂志, 2018, 36(6): 10-14.

［10］ Zeng ShQ, Ma L, Zhang L, et al. Anatomical morphometry of the coracoid and its clinical significance in Chniese population based on three-dimensional reconstruction of CT［J］. Acta Anatomica Sinica, 2019, 50(2): 227-231.（in Chinese）

曾胜强, 马丽, 张磊, 等. 基于CT三维重建的中国人喙突形态学测量及临床意义［J］. 解剖学报, 2019, 50(2): 227-231.

［11］ Zhang ZhH, Wang LB, Cui WM, et al. Anatomy of the scapulae safety prediction［J］. Acta Anatomica Sinica, 2017, 48(1): 65-69.（in Chinese）

张振华, 王立博, 崔雯铭, 等. 肩胛骨安全区的解剖［J］. 解剖学报, 2017, 48(1): 65-69.

［12］ Sella GDV, Miyazaki AN, Nico MAC, et al. Study on the anatomic relationship between the clavicle and the coracoid process using computed tomography scans of the shoulder［J］. J Shoulder Elbow Surg, 2017, 26(10): 1740-1747.

［13］ Chaudhary D, Jain V, Joshi D, et al. Arthroscopic fixation for acute acromioclavicular joint disruption using the tightrope device［J］. J Orthop Surg, 2015, 23(3): 309-314.

［14］ Modi CS, Beazley J, Zywiel MG, et al. Controversies relating to the management of acromioclavicular joint dislocations［J］. Bone Joint J, 2013, 95(12): 1595-1602.

［15］ Salzmann GM, Walz L, Buchmann S, et al. Arthroscopically assisted 2-bundle anatomical reduction of acute acromioclavicular joint separations［J］. Am J Sports Med, 2010, 38(6): 1179-1187.

［16］ Wei HF, Chen YF, Zeng BF, et al. Triple endobuttton technique for the treatment of acute complete acromioclavicular joint dislocations: preliminary results［J］. Int Orthop, 2011, 35(4): 555-559.

［17］ Weaver JK. Treatment of acromioclavicular injuries, especially complete acromioclavicular separation［J］. J Bone Joint Surg Am, 1972, 54(6): 1187-1194.

［18］ Deshmukh AV, Wilson DR, Zilberfarb JL, et al. Stability of acromioclavicular joint reconstruction: biomechanical testing of various surgical techniques in a cadaveric model［J］. Am J Sports Med, 2004, 32(6): 1492-1498.

［19］ Michlitsch MG, Adamson GJ, Pink M, et al. Biomechanical comparison of a modified Weaver-Dunn and a free-tissue graft reconstruction of the acromioclavicular joint complex［J］. Am J Sports Med, 2010, 38(6): 1196-1203.

［20］ Rylander LS, Baldini T, Mitchell JJ, et al. Coracoclavicular ligament reconstruction: coracoid tunnel diameter correlates with failure risk［J］. Orthopedics, 2014, 37(6): e531-e535.

［21］ Renfree KJ, Riley MK, Wheeler D, et al. Ligamentous anatomy of the distal clavicle［J］. J Shoulder Elbow Surg, 2003, 12(4):355-359.