The oblique cord of the forearm in man

There is minimal and often conflicting data in the literature regarding the oblique cord of the forearm. The current study seeks to elucidate further the anatomy of this structure of the upper extremity. In adult cadavers, the oblique cord was observed for and, when found, measurements were made of it. Ranges of motion were carried out while observation of the oblique cord was made. An oblique cord was found on 52.6% of sides. Gantzer's muscle was found on 55% of sides and, when present, had attachment into the oblique cord on five sides. The oblique cord was present on 13 sides with a Gantzer's muscle. Of the 20 sides with an oblique cord, no Gantzer's muscle was found on 10. The mean length of the oblique cord was 3.4 cm. In the majority of specimens, this cord tapered from proximal to distal. The proximal, middle, and distal widths of this structure had means 9, 7, and 4 mm, respectively. The oblique cord was found to travel approximately 45 degrees from a line drawn through the ulna and more or less traveled perpendicular to the insertion site of the bicipital tendon. This ligament was lax in the neutral position and with pronation became lax in all specimens. The oblique cord progressively became taut with increased supination from the neutral position and was maximally taut with the forearm fully supinated. Tautness of this cord was also found with distal distraction of the radius. Following the transection of the oblique cord, no discernable difference was observed in regard to maximal supination of the forearm or distal distraction of the radius. No obvious instability of the proximal forearm was found following transection of the oblique cord. Functionally, although the oblique cord may resist supination, it is unlikely that this structure affords significant stability to the proximal forearm, as it was often absent, of a very small caliber, and based on our observations, following its transection, the amount of supination of the forearm did not increase. Moreover, one would expect that this structure would never resist supination alone, as the larger overlying muscles would become taut prior to calling upon the action of this cord. Based on our findings, the function of the oblique cord appears insignificant in providing significant stability to the proximal forearm; however, further investigative studies are now necessary to confirm these data.     

尺桡骨生理角度的观测

对205侧尺骨和桡骨的生理角度进行了观测。就桡骨的生理性弧度、前倾角、内倾角、尺骨生理性弧度作了测量。测得数据进行了处理,提出可供临床参考的有关资料。     

桡侧腕屈肌腱部分移位修复桡尺远侧关节脱位的解剖与临床

目的：为桡尺远侧关节脱位修复提代术式设计的解部学依据。方法：30侧成人上肢标本,对桡侧腕屈肌腱进行形态学侧量。结果：桡侧腕屈肌腱性部分长14.3±1.1cm,肌腱上、中、下段宽分别为9.1±1.4mm,5.5±0.9mm和4.2±0.4mm,肌腱上、中、下段厚分别为2.4±0.6mm、2.2±0.4mm和2.6±0.5mm。结论：桡侧腕屈肌腱部分转位有足够的长度和强度,修复桡尺远侧关节脱位的术式设计具有可行性,是一种新的手术方法,临床广泛应用和9例,获得良好效果。     

In vivo measurement of fascicle length and pennation of the human anconeus muscle at several elbow joint angles

Ultrasound imaging has facilitated the reliable measure of the architectural variables fascicle length (L_F) and pennation angle (PA), at rest and during static and dynamic contractions in many human skeletal muscles in vivo. Despite its small size and very modest contribution to elbow extension torque, the anconeus muscle has proven a useful model for the study of neuromuscular function in health and disease. Recent single motor unit (MU) studies in the anconeus have reported discrete and identifiable individual trains of MU potentials from intramuscular electromyography (EMG) recordings during dynamic elbow extensions. It is unknown whether the anconeus has unique architectural features related to alterations in L_F and PA throughout the elbow joint range of motion that may help explain these high-quality recordings. Previous anatomical studies have investigated this muscle in cadavers and at mainly one elbow joint angle. The purpose of this study was to measure in vivo PA and L_F of the anconeus muscle in a relaxed state at different degrees of elbow flexion using ultrasonography. Ultrasound images were collected from 10 healthy males (25 ± 3 years) at 135°, 120°, 90°, 45°, and 0° of elbow flexion. Average values of L_F decreased by 6 mm (10%), 6 mm (12%), and 4 mm (9%) from 135–120°, 120–90°, and 90–45° of elbow flexion, respectively, whereas average PA values increased by 1° (9%), 1° (8%), and 2° (14%) from 135–120°, 120–90°, and 45–0°, respectively. The results indicate that anconeus muscle architecture is dynamic, undergoing moderate changes with elbow joint excursion that are similar to other limb muscles reported elsewhere. The data obtained here are more comprehensive and representative of architectural changes at various elbow joint positions than those data reported in cadaveric studies. Furthermore, the results of this study indicate that despite experiencing similar relative changes in muscle architecture to other skeletal muscles about the elbow joint, the minimal absolute changes in L_F of the anconeus likely contribute to the clarity of intramuscular EMG previously reported in this muscle.     

Ages of Epiphyseal Union Around Wrist Joint - A Radiological Study

Age is an important parameter for medico-legal cases. Many times doctors are called upon togive opinion about age of a person. For this objective methods of age determination are required. Age of epiphyseal union is an objective important method of age determination. But these ages varies with racial, geographic, climatic and various other factors. These variations have suggested need of separate standards of ossification for separate regions.Present work is undertaken to work out ages of epiphyseal union around wrist joint for Vidarbha region. Study is carried out in total 80 healthy subjects (44 girls and 36 boys) aging from 13 to 23 years &; having length of residence in Vidarbha not less than 10 years. The chronological age upto the day of examination is determined &; A-P view of right wrist joint is taken in each case. These radiographs are studied to determine age of union of epiphyses of lower end of radius &; lower end of ulna. These ages are compared with those reported from various states of India &; also from other countries &; found to vary appreciably. Sexual dimorphism for ages of epiphyseal union is also studied.     

The twisted structure of the rat Achilles tendon

The rat is frequently used as a model to study the characteristics, aetiology and pathology of the Achilles tendon. However, though the structure of the human Achilles tendon has been extensively investigated, the anatomical structure of the rat Achilles tendon remains unclear, which impedes the ability to use rats to study Achilles tendinopathy. The purpose of this study was to reveal the structure of the rat Achilles tendon and to explore its similarities with the human Achilles tendon through an anatomical dissection of 80 rat Achilles tendons (40 female, 40 male). This study found that the subtendons of the rat Achilles tendon originating from the triceps surae muscle were twisted, and each subtendon also had its own torsion. The extent of these two types of torsion could be very different between rats. Alterations in this torsion may result in distinct stress fields in the Achilles tendon, which may play a critical role in the pathogenesis of Achilles tendinopathy. This study provides an important basis to support the use of rats as model animals to investigate the characteristics of the human Achilles tendon and Achilles tendinopathy.     

以骨间后血管为蒂的邻近骨膜瓣在前臂骨不连中的应用

目的：报道以骨间后血管为蒂的邻近骨膜瓣治疗前臂骨不连的方法。方法：在传统的骨缺损端游离植骨的基础上，外包以骨间后血管为蒂的邻近骨膜瓣治疗前臂骨不连１６例。结果：经随访６～１８个月，效果良好，无一例出现骨不连。结论：此手术简单，易掌握，疗效确切可靠，不失为治疗前臂骨不连，骨缺损不多患者的理想方法     

Moderate Joint Loading Reduces Degenerative Actions of Matrix Metalloproteinases in the Articular Cartilage of Mouse Ulnae

Joint loading is a recently developed loading modality, which can enhance bone formation and accelerate healing of bone fracture. Since mechanical stimulation alters expression of matrix metalloproteinases (MMPs) in chondrocytes, a question addressed herein was, does joint loading alter actions of MMPs in the articular cartilage? We hypothesized that expression and activity of MMPs are regulated in a load–intensity-dependent manner and that moderate load scan downregulates MMPs. To test this hypothesis, a mouse elbow-loading model was employed. In the articular cartilage of an ulna, the mRNA levels of a group of MMPs as well as their degenerative activities were determined. The result revealed that elbow loading altered the expression and activities of MMPs depending on its loading intensity. Collectively, the data in this study indicate that 0.2 and 0.5 N joint loading significantly reduced the expression of multiple MMPs, that is, MMP-1, MMP-3, MMP-8, and MMP-13, and overall activities of collagenases or gelatinases in articular cartilage, while higher loads increased the expression and activity of MMP-1 and MMP-13. Furthermore, moderate loads at 1 N elevated the mRNA level of CBP/p300-interacting transactivator with ED-rich tail 2 (CITED2), but higher loads at 4 N did not induce a detectable amount of CITED2 mRNA. Since CITED2 is known to mediate the downregulation of MMP-1 and MMP-13, the result indicates that joint loading at moderate intensity reduces MMP activities through potential induction of CITED2. MMPs such as MMP-1 and MMP-13 are predominant collagenases in the pathology of osteoarthritis. Therefore, joint loading could offer an interventional regimen for maintenance of joint tissues.     

Computerized anatomy of the distal radius and its relevance to volar plating,research, and teaching

Distal radius fractures are common and fracture patterns and fixation can be complex. Computerized anatomy evaluation (CAE) might offer non‐invasive and enhanced anatomy assessment that might help with implant selection and placement and screw length determination. Our goal was to test the accuracy of two CAE methods for anatomical volar plate positioning and screw lengths measurement of the distal radius. We included 56 high‐resolution peripheral quantitative computed tomography scans of intact, human distal radii. Plates were placed manually onto 3D printed models (method 1), which was compared with automated computerized plate placement onto the 3D computer models (method 2). Subsequently, screw lengths were determined digitally for both methods. Screw lengths evaluations were compared via Bland–Altman plots. Both CAE methods resulted in identical volar plate selection and in anatomical plate positioning. For screw length the concordance correlation coefficient was ≥0.91, the location shift ≤0.22 mm, and the scale shift ≤0.16. The differences were smaller than ±1 mm in all samples. Both CAE methods allow for comparable plate positioning and subsequent screw length measurement in distal radius volar plating. Both can be used as a non‐invasive teaching environment for volar plate fixation. Method 2 even offers fully computerized assessments. Future studies could compare our models to other anatomical areas, post‐operative volar plate positioning, and model performance in actual distal radius fracture instead of intact radii. Clin. Anat. 32:361–368, 2019. © 2018 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.     

The influence of aging on the insertion of the Achilles tendon: A magnetic resonance study

The aim of this study was to examine the variations of the Achilles tendon (AT) insertion point into the calcaneal bone (CB) in relation to age and sex using magnetic resonance imaging (MRI). A total of 202 foot and ankle MRIs were reviewed and patients were allocated into three age groups: (I) <18, (II) 18-65, and (III) >65 years. All measurements were obtained on a mid-sagittal scan. The mean measurement values were used to assess the relationships among the AT insertion point, sex, and age. Our main findings revealed that (1) the distance between the most inferior point of the CB and the most inferior part of the AT insertion into the CB increases with age, (2) the height of the AT insertion into the posterior aspect of the CB decreases with age, and (3) the length of the AT insertion into the posterior aspect of the CB decreases with age. The terminal insertion point of the AT on the CB in younger subjects was more distal, whereas in older individuals it was more proximal. These results could help in developing novel strategies for the treatment and prophylaxis of AT injuries in particular patient age groups. Anatomical data about the AT insertion are crucial for developing a computer model of the AT and for biomechanical considerations regarding this tendon. Clin. Anat. 33:545–551, 2020. © 2019 Wiley Periodicals, Inc.     

儿童肘部的断层解剖及临床意义

目的：为临床儿童肘部疾病的断层解剖影像学检查提供形态学基础，方法：采用18侧不同年龄儿童尸体肘部标本经X线摄片后，制作水平面，矢状面及冠状面标本，观察各断面解剖结构和关系，并与成人断面解剖进行比较分析。结果：儿童肘部各断面的解剖结构和排列关系类似成人，但儿童肘部软骨性成份较多。年龄赵小，软骨比例越大。结论：（1）X线片对软骨性结构的显示不能提供帮助。（2）儿童肘部的断层解剖由于骨骺发育的不断阶段而有别于成人；（3）本研究为儿童肘部疾病特别软骨性结构损伤的断层影像学检查如MRI、US等的临床应用打下形态学基础。     

手部A2滑车的解剖学及Ⅱc亚区内肌腱的滑动

目的 :研究手部指屈肌腱功能最为重要的A2 滑车的解剖学及其所在区域 (Ⅱc亚区 )内肌腱的滑动。方法 :本研究采用 1 0只成人尸体手共 40个手指 ,观察A2 滑车的位置 ,并测定其长度、管径的垂直高度和横径 ;测定指深、浅屈肌腱由Ⅱb亚区向A2 滑车区域以及A2 滑车向Ⅱd亚区的滑动幅度。切开 1 0个中指测定A2 滑车近侧半或远侧半时手指屈曲度总和。结果 :A2 滑车位于的节指骨中部和近侧A2 滑车长度为近节指骨长度的 2 / 3。A2 滑车的中部口径是为细小 ,在手指完全屈曲时 ,几乎整个长度的Ⅱc亚区内指深屈腱滑动至Ⅱd亚区 ,切开A2 滑车近侧或远侧半对手指屈曲功能影响很小。结论 :A2 滑车的解剖学位置和形态特殊 ,A2 滑车中远部份最为细缩 ,部分切开A2 滑车对肌腱功能影响不明显。本研究还提示Ⅱd亚区鞘管对Ⅱc亚区内肌腱功能有很大影响     

肘前内侧血管神经间隙入路的临床解剖学

目的　对肘前内侧血管神经等相关结构进行解剖研究,为肘关节相关手术提供更佳的手术入路。 方法　 福尔马林防腐动脉灌注红色乳胶成人尸体上肢标本20侧,按层次解剖,从肱桡肌及旋前圆肌间隙进入,通过正中神经与肱、尺动脉之间的血管神经间隙,显露肘前侧解剖结构。观察肱动脉、桡动脉和尺动脉向内、外侧的分支,测量分支到桡、尺动脉分叉处的距离,分支管径;观察正中神经及分支走行情况,测量神经与血管伴行无相互交叉分支距离。 结果　血管神经无互相交叉分支伴行长度平均为6.04 cm,两者之间无重要分支相交叉,易于向两侧分开,能够清楚地提供肘关节相应部位的暴露。动脉向内侧分支较向外侧分支少且细,易于向外侧牵拉。神经肌支,基本上向内侧发出,以极小的锐角从主干发出,几乎与主干平行,易于向内侧牵拉。 结论　肘前内侧血管神经间隙入路,可保护血管神经,能清楚显露肘关节前侧解剖结构,易于操作。     

Anatomical relationship between the morphology of the styloid process of the ulna and the attachment of the radioulnar ligaments

The radioulnar ligaments are the major stabilizers of the distal radioulnar joint under dynamic loading; however, anatomical detail regarding their attachment on the middle and distal thirds of the styloid process of the ulna remains unclear. Because previous anatomical studies included only old cadavers, their anatomical findings might not reflect the morphological features of younger and healthy specimens. This study investigated the anatomical features of the distal ulna, particularly the styloid process, to determine the attachment of the radioulnar ligaments to the styloid process and verified their direction and attachment to the styloid process in younger and healthy donors using magnetic resonance imaging (MRI). We investigated the morphological features of the distal ulna of 12 cadaveric wrists using micro-computed tomography (micro-CT). We also visualized and measured the distribution of the cortical bone thickness. We histologically analyzed three specimens in the axial plane and macroscopically analyzed seven specimens to examine the attachment of the radioulnar ligaments to the styloid process. In addition, we evaluated five wrists from living volunteers using 3.0 Tesla MRI. The distal ulna has a ridge on the dorsoradial aspect of the styloid process that corresponds to the attachment of the radioulnar ligaments. Micro-CT images after data processing revealed that the cortical thickness of the dorsoradial quadrant was thicker than that of the other quadrant at the proximal slice of the styloid process (p < 0.01), and that of the dorsoulnar (p = 0.021) and ulnopalmar (p < 0.01) quadrants at the middle slice. Histological analyses showed that the radioulnar ligaments were attached to the middle and distal thirds of the styloid process via chondral-apophyseal entheses. The direction of the fiber was dorsal in the middle third of the styloid process and changed to palmar in the distal third of the styloid process. The direction and attachment of the radioulnar ligaments on the styloid process were confirmed using MRI for younger and healthy participants. The radioulnar ligaments were attached to the dorsoradial ridge of the styloid process, which was confirmed by cortical bone thickening, histology at the attachment sites, and in vivo MR imaging. The directions of the radioulnar ligaments sterically intersected, which would satisfy both slipping stability and rotational mobility. These anatomical findings may provide the basis for biomechanical consideration of distal radioulnar joint stabilization.     

基于尺桡骨三维有限元模型分析桡骨远端骨折的生物力学特征

文题释义： 三维有限元模型：有限元模型主要是利用有限元分析方法建立的模型,而三维有限元模型主要是根据空间有限离散原则,将三维空间结构体分割不同区域,各区域为一单元且以节点相连接,因此节点间的变形运动是连续的,会引起周围节点及单元的相关变化。三维有限元模型精确逼真,且符合桡骨远端骨折的生物力学特性,模拟测试结果可为临床研究提供理论依据。 桡骨远端骨折：特指距桡骨远端关节面3 cm以内的骨折,常见于患者跌倒时损伤,是中老年人好发骨折之一,约占全部骨折患者的1/6。 背景：近年来关于桡骨远端骨折机制偏向定性的研究多数仅限于二维分析,易受多种因素影响,导致结果不甚满意,而利用CT数据建立三维有限元模型可更好评估人体骨骼变异情况。 目的：通过建立尺桡骨三维有限元模型,检测桡骨远端骨折生物力学,并进行桡骨远端骨折发生机制研究。 方法：获取1名50岁健康女性左侧上肢肱骨远端到腕关节中段CT扫描影像学资料,志愿者对试验方案知情同意,且经CT扫描显示正常,排除患有骨科相关疾病。利用三维有限元分析软件Ansys 16.0建立尺桡骨三维有限元模型,模拟手腕背伸、掌屈、尺偏、桡偏时力的加载,观察记录不同载荷下模型各部分应力;分析不同模型角度时桡骨远端骨折形成及裂纹走向。 结果与结论：①腕关节处于背伸位时,前臂旋前和前臂旋后桡骨背侧缘中点受压应力,随背伸角度增大而增大;前臂旋前和前臂旋后桡骨掌侧受张应力,随背伸角度增大而增大;②腕关节处于掌屈位时,前臂旋前和前臂旋后桡骨背侧缘中点受张应力,随掌屈角度增大而增大;前臂旋前和前臂旋后桡骨掌侧受压应力,随掌屈角度增大而增大;③前臂旋前背伸位及前臂旋后掌屈位时,桡骨裂纹首先出现于松质骨与密质骨交界处桡骨远端表面受最大张力一侧,骨折裂纹沿掌远端向近背端,与骨轴线45°角方向发展;④前臂旋前掌屈位及前臂旋后背伸位时,桡骨裂纹首先出现于松质骨与密质骨交界处桡骨远端表面受最大张力一侧,骨折裂纹沿远背端向近掌侧,与骨轴线45°角方向发展;⑤结果表明,手腕背伸、掌屈、尺偏、桡偏进行力的加载,骨折首先出现于松质骨与密质骨交界处桡骨远端表面受最大张力一侧,裂纹走向与所受应切力和张应力方向有关。 ORCID: 0000-0002-4577-2165(夏长江) 中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

The clinical surface anatomy anomalies of the palmaris longus muscle in the Black African population of Zimbabwe and a proposed new testing technique

The presence of the palmaris longus muscle (PLM) is highly variable. Rates of absence vary from 0.6% in the Korean population to as high as 63.9% in the Turkish population. The tendon of PLM may be absent on one or both forearms, may have duplicated tendons on one forearm or may be laterally shifted to the extent that the tendon of the PLM lies superficial to that of flexor carpi radialis muscle. Among Black American populations, in which there is usually mixed ancestry, rates of absence are 3.5%. Only two studies have been performed on Black African populations: in Republic of Congo and Uganda, and each showed widely differing rates of absence of 3.0% and 14.6%, respectively. In this study, a total of 890 Black Zimbabwean subjects in Harare aged between 8 and 13 years, were examined for clinical surface anatomy anomalies of the tendon of PLM. The results showed that the tendon of the PLM was absent unilaterally in 0.9% of the population, and bilaterally absent in 0.6% with an overall rate of absence of 1.5%. Other variations noted were a laterally shifted PLM in 1.1% of subjects and duplicated tendons on one forearm, which was the least prevalent anomaly, in 0.2% of subjects. The author proposes a new technique to test the tendon of PLM, which combines resisted thumb abduction and resisted wrist flexion. The proposed technique capitalizes on the role of the PLM as an important abductor of the thumb. Clin. Anat. 22:230–235, 2009. © 2009 Wiley‐Liss, Inc.     

蒙医整骨治疗尺桡骨骨折力学原理的有限元分析

文题释义：蒙医整骨术：是蒙古族历代医者们所积累的、具有蒙古民族特色的治疗骨折与脱臼、软组织损伤等一系列整骨疗法的总称。蒙医整骨方法简练、手法简单,具有可靠的临床效果。蒙医整骨讲究“机触于处,巧生于内,手随心转,法从手出”。实施疗法的时候,需要重视人体生理功能之内在作用,注意保护人体骨骼之完整性,最大限度地发挥组织器官的自愈能力,使伤折部位及早愈合,恢复正常生理功能。尺桡骨三维模型建立：当前科研活动当中主要使用直接建模、坐标点建模、组织切片建模,基于医学图像建模,和DICOM数据直接建模。其中基于CT数据的DICOM数据建模方法因为数据来源准确而且建模过程不需要人为干预,成为有限元分析过程中最常用的建模方法。背景：目前中国蒙医整骨术以手法繁复、理论驳杂著称,结合尺桡骨骨折有限元断裂模型专门进行力学原理分析的阐述,国内外未见相关报道。目的：模拟尺桡骨各类骨折受力情况,建立尺桡骨骨折断裂模型,评估模型效果,并分析蒙医整骨对应骨折的手法机制。方法：选择1名35岁男性志愿者,签署知情同意书后获取右臂前肢CT影像资料,建立尺桡骨几何模型,依据骨组织技术指标设定材料参数,划分网格,赋予载荷参数,进行分析运算。以Colles骨折与Smith骨折常见损伤原因为判断依据,结合蒙医整骨“以力对力”原则进行整骨手法判断。结果与结论：①尺桡骨的骨折模型应力分布情况与以往对前臂的研究高度符合,在对应力方向获得了伸直性、屈曲性骨折的力学模型,调整骨质力学参数后成功模拟出4种年龄段的不同骨折模型;②结果证明,能够较好的模拟尺桡骨骨折断裂情况,从而为蒙医整骨“以力对力”治疗尺桡骨骨折提供手法参考。 ORCID: 0000-0003-4940-7891(李忠贤)中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

The arterial anatomy of the Achilles tendon: Anatomical study and clinical implications

The Achilles tendon is the most frequently ruptured tendon in the lower limb and accounts for almost 20% of all large tendon injuries. Despite numerous published studies describing its blood supply, there has been no uniformity in describing its topography. The current study comprises a detailed anatomical study of both the intrinsic and extrinsic arterial supply of the Achilles tendon, providing the detail sought from studies calling for improved planning of surgical procedures where damage to the vascularity of the Achilles tendon is likely. A dissection, microdissection, histological, and angiographic study was undertaken on 20 cadaveric lower limbs from 16 fresh and four embalmed cadavers. The Achilles tendon is supplied by two arteries, the posterior tibial and peroneal arteries. Three vascular territories were identified, with the midsection supplied by the peroneal artery, and the proximal and distal sections supplied by the posterior tibial artery. The midsection of the Achilles tendon was markedly more hypovascular that the rest of the tendon. The Achilles tendon is at highest risk of rupture and surgical complications at its midsection. Individuals with particularly poor supply of the midsection may be at increased risk of tendon rupture, and approaches to the tendon operatively should consider the route of supply by the peroneal artery to this susceptible part of the tendon. Clin. Anat. 22:377–385, 2009. © 2009 Wiley‐Liss, Inc.     

夹板与石膏管型外固定物治疗儿童前臂远端隆突样骨折的系统评价

背景：儿童前臂远端隆突样骨折一般无继发移位风险,文献报道可通过石膏管型、掌侧托、夹板、支具以及绷带等外固定物治疗获得满意疗效。但是不同外固定物治疗对患儿功能恢复及生活能力的影响并不明确。 目的：评价夹板与石膏管型外固定物治疗儿童前臂远端隆突样骨折的疗效和安全性。 方法：计算机检索Medline、Embase、Cochrane 图书馆(2011年第3期)及中国生物医学数据库、中国期刊全文数据库,检索时限为建库至2011年4月;手工检索相关会议论文;在线检索重要临床试验注册中心,文献检索无语种限制。收集随机对照及半随机对照试验,行质量评价并采用Revman 5.1行Meta分析。 结果与结论：纳入2项研究,包括314例患者,1项随机对照试验评价为B级,1项半随机对照试验评价为C级。结果表明,夹板与石膏管型外固定物治疗后均无骨折、骨折不愈合以及再骨折,患肢疼痛以及书写、绘画、自理饮食、洗漱4方面生活能力差异无显著性意义;而固定后患儿洗澡能力夹板组早期优于石膏管型组,后期差异无显著性意义。参加规律运动方面亦为夹板固定组优于石膏管型固定组。两种固定方法不良事件发生率比较差异无显著性意义。提示夹板与石膏管型外固定物治疗儿童前臂远端隆突样骨折后患肢疼痛无明显改善,但夹板固定有利于维持洗澡能力及参加规律运动,且安全性良好。但仍需设计良好、实施完善的大样本、多中心随机对照试验验证。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程全文链接：     

自体骨—肌腿移植的解剖学研究

目的为临床治疗垂状指及屈肌腱止点重建的新方法提供解剖学依据.方法对20具40侧成人尸体的跟骨-跖肌腱、第1掌骨-拇长展肌、第2掌骨-桡侧腕长伸肌可行供区,进行止点类型、附着点面积、可切取骨块情况、以及相邻解剖结构和解剖变异等方面进行解剖学研究.并用SPSS统计软件进行统计和分析.结果.①90%的跖肌腱直接附着于跟骨而不与跟腱融合(集中型占85%),止点面积为(69.5±4.4)mm2;②93%拇长展肌腱直接附着于第1掌骨基底部桡侧(集中型占87%),止点面积为(27.9±3.4)mm2;③90%桡侧腕长伸肌腱直接附着于第2掌骨背侧或大于1/2桡背侧(集中型占90%),止点面积为(31.6±4.2)mm2.切取骨块形状分为椭圆形(平均占12%)、横形(平均占8%)、圆形(平均占7%)、弥散形(平均占13%).结论①跟骨-跖肌腱、部分第1掌骨-桡侧腕长伸肌和第2掌骨-拇长展肌的肌腱附着点形状、面积、可切取的骨块都能满足骨-肌腱移植的要求;②切取3个骨-肌腱供区对手足功能无任何影响,为临床构制骨-肌腱移植提供了解剖学依据.