成人肘肌肌构筑学及肌内神经分布模式

刘建; 朱光琼; 刘坤祥

doi:10.16098/j.issn.0529-1356.2023.05.012

PDF(2595 KB)

解剖学报 ›› 2023, Vol. 54 ›› Issue (5) : 582-585. DOI: 10.16098/j.issn.0529-1356.2023.05.012

解剖学

成人肘肌肌构筑学及肌内神经分布模式

刘建朱光琼刘坤祥*

作者信息 +

Muscle architecture and intramuscular nerve distribution pattern of adult elbow muscle

LIU Jian ZHU Guang-qiong LIU Kun-xiang*

Author information +

文章历史 +

摘要

目的探讨肘肌的形态、肌构筑学指数和肌内神经密集区的分布模式，为肘关节后外侧入路手术及肘肌肌瓣移植提供解剖学定位。方法选取成人肘肌共10例，平均年龄64.2岁，采用大体解剖法、肌构筑学指数法和改良Sihler肌内神经染色法。结果肘肌近似三角形，肌湿重（6.31±0.85）g，肌长（6.24±0.78）cm，肌纤维长（4.74±0.88）cm，羽状角（70.60±6.41）°，肌生理横切面积（0.41±0.15）cm2。桡神经深支的分支在距起点肌腹长26.17%处分成上、中、下3支至肘肌中部，吻合形成丛。结论肘肌为半羽肌；依据肌内神经密集区的位置，可考虑行肘肌肌瓣移植及靠近肌的下部行肘关节后外侧手术入路。

Abstract

Objective To study the morphology, muscle architecture index and distribution pattern of intramuscular nerve dense area of elbow muscle, so as to provide anatomical location for poster-lateral approach of elbow joint and transplantation of elbow muscle flap. Methods Through gross anatomy, muscle architecture index and modified Sihler’s intramuscular nerve staining, 10 cases with an average age of 64.2 years were selected. Results The elbow muscle was approximate triangle, the muscle wet weight was (6.31±0.85) g, the muscle length was (6.24±0.78) cm, the muscle fiber length was (4.74±0.88) cm, pennation angle（70.60±6.41）°and the muscle physiological cross-sectional area was (0.41±0.15) cm2. The branches of the deep branch of the radial nerve were divided into upper, middle and lower branches at the distance of 26.17% from the abdominal length of the starting muscle to the middle of the elbow muscle, and anastomosed to form a plexus. Conclusion The elbow muscle is hemi-pennate muscle；According to the location of intramuscular nerve dense area, elbow muscle flap transplantation can be considered，the posterolateral approach of elbow joint can be performed near the lower part of muscle.

导出引用

刘建朱光琼刘坤祥. 成人肘肌肌构筑学及肌内神经分布模式[J]. 解剖学报. 2023, 54(5): 582-585 https://doi.org/10.16098/j.issn.0529-1356.2023.05.012

LIU Jian ZHU Guang-qiong LIU Kun-xiang. Muscle architecture and intramuscular nerve distribution pattern of adult elbow muscle[J]. Acta Anatomica Sinica. 2023, 54(5): 582-585 https://doi.org/10.16098/j.issn.0529-1356.2023.05.012

中图分类号： R322.74

参考文献

［1］Byung JJ, Seung JJ, Dong CL, et al. The anconeus muscle free flap: clinical application to lesions on the hand［J］. Arch Plast Surg, 2017,44(5):420-427.
［2］Li J, Wang JN, Tong ZhH. Anatomic study of anconeus muscle flap［J］. Chinese Journal of Practical Hand Surgery, 2004,18(3):156-157. (in Chinese)
李晋,王江宁,童致虹. 肘肌肌瓣的解剖学研究［J］.实用手外科杂志,2004,18(3):156-157.
［3］Gao WJ, Shi ZY, Han YK, et al. Anatomy of anconeus free muscle flap for restoration of thumb oppositional function［J］. Acta Anatomica Sinica, 2018, 49(3):355-360. (in Chinese)
高文静, 史紫堉, 韩轶锴,等.肘肌游离肌瓣重建拇指对掌功能的解剖［J］.解剖学报,2018,49(3):355-360.
［4］Sun HJ, Xu DQ, Xia ChL, et al. Applied anatomy of arthroplasty of elbow adopting anconeus［J］. Chinese Journal of Clinical Anatomy,2007,25(4):373-375. (in Chinese)
孙焕建,徐达强,夏春林,等. 肘肌肘关节成形术的应用解剖学研究［J］.中国临床解剖学杂志,2007,25(4):373-375.
［5］Barry PP. Revisiting the anatomy and biomechanics of the anconeus muscle and its role in elbow stability［J］.Ann Anat,2013,195 (4):365-370.
［6］Amirali A, Mu L, Gracies JM, et al. Anatomical localization of motor endplate bands in the human biceps brachii［J］. J Clin Neuromuscul Dis,2007,9(2):306-312.
［7］Yan XC, Liu J, Liu B,et al. Procedure of reconstructing transverse arch of the forefoot by transferring tendons for correcting hallux valgus［J］. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi,2015,29(4):412-415.
［8］Zhang ZP, Liu J. Compartmentalization and architecture features in nerve branch and distribution of the human psoas minor［J］.Journal of Zunyi Medical College,2013,36(6):518-524.(in Chinese)
张子萍,刘建.人腰小肌肌亚部构筑特点和肌内神经的分支分布［J］.遵义医学院学报,2013,36(6):518-524.
［9］Ward SR,Lieber RL. Density and hydration of fresh and fixed human skeletal muscle［J］.J Biomech,2005,38(11):2317-2320.
［10］Zhu GQ, Liu J, Ding JY, et al. Experimental studies on the muscular architecture and intramuscular nerve distribution patterns of serratus posterior superior in human［J］.Sichuan Journal of Anatomy,2016,24(2):1-3.(in Chinese)
朱光琼,刘建,丁九阳,等.上后锯肌肌构筑及肌内神经分布的实验研究［J］.四川解剖学杂志,2016,24(2):1-3.
［11］Azboy B, Bulut M, Ancar C,et al. The comparison of triceps-reflecting anconeus pedicle and olecranon osteotomy approaches in the treatment of intercondylar fractures of the humerus［J］. Ulus Travma Acil Cerrahi Derg,2016,22(1):58-65.
［12］Mittal A, Gill S, Raj M, et al. Management of intercondylar fractures of the humerus by triceps-reflecting anconeus pedicle (TRAP) and olecranon osteotomy approaches-A comparative study［J］. J Arthrosc Joint Surg,2020,8(2):1-9.
［13］Lu ShJ. Clinical effect of triceps-elbow muscle approach for the treatment of comminuted humeral condyle fracture［J］.Genomics and Applied Biology,2018,34(10):4633-4638. (in Chinese)
陆圣君.肱三头肌肘肌瓣入路治疗肱骨髁间粉碎性骨折的临床疗效［J］.基因组学与应用生物学,2018,34(10):4633-4638.
［14］Sun HJ, Wu JD, Zhu WF, et al. Modified anconeus flap approach for intercondylar humerus fractures［J］. Chinese Journal of Orthopaedic Trauma,2016,18(7):586-591. (in Chinese)
孙焕建,吴加东,朱文峰,等.改良肘肌瓣入路治疗肱骨髁间骨折［J］.中华创伤骨科杂志,2016,18(7):586-591.
［15］Jiménez-Díaz V, Aragonés P, García-Lamas L, et al. The anconeus muscle revisited: double innervation pattern and its clinical implications［J］. Surg Radiol Anat,2021,43(10):1595-1601.
［16］Stevens DE, Smith CB, Harwood B, et al. In vivo measurement of fascicle length and pennation of the human anconeus muscle at several elbow joint angles［J］. J Anat,2015,225(5):502-509.
［17］Duchenne GB, Kaplan EB, Straus WL, et al. Physiology of motion demonstrated by means of electrical stimulation and clinical observation and applied to the study of paralysis and deformities［J］. Quarterly Rev Biol,1951,141(1):2150-2151.
［18］Coriolano MG, Lins OG, Amorim MJ, et al. Anatomy and functional architecture of the anconeus muscle［J］. Int J Morphol,2009, 27(4): 1009-1012.
［19］Li ShT, Wu XY, Tang Q, et al. Muscular architecture and distribution of intramuscular nerves in popliteus of human［J］. Chinese Journal of Clinical Anatomy,2013,31(2):147-149.(in Chinese)
李寿田,吴小艳,唐谦,等.腘肌肌构筑学和肌内神经的研究［J］.中国临床解剖学杂志,2013,31(2):147-149.
［20］Won SY, Kim DH, Yang HM, et al. Clinical and anatomical approach using Sihler’s staining technique (whole mount nerve stain)［J］.Anat Cell Biol,2011,44(1):1-7.
［21］Mu L, Sanders I. Sihler’s whole mount nerve staining technique:a review［J］.Biotech Histochem,2010,85(1):19-42.