肱二头肌长头肌腱断裂一例报告

患者男 ,4 9岁 ,农民。因帮别人抬车时突闻右肩部有断裂响声 ,并感到肩部剧烈疼痛 ,活动受限。于两日后由家人陪同到我科求治 ,查体 :右上臂掌侧中1/ 3处出现一软组织包块 ,用力作抗阻力屈肘时 ,包块显得更为明显 ,肱骨结节沟处压痛 ,肩部肿胀 ,屈肘乏力 ,右肩旋转 ,外展功能受     

探头扫查平面与肌纤维走行方向夹角对剪切波传播速度的影响

目的 探讨探头扫查平面与肱二头肌肌纤维走行方向夹角对剪切波传播速度的影响。方法 随机选取健康志愿者20名。采用实时剪切波弹性成像技术, 探头方向与肌纤维方向夹角分别为0°、30°、60°、90°,测量距体表深度1.7 cm、2.5 cm处同一位点的剪切波传播速度,并进行统计学分析。结果 深度为1.7 cm和2.5 cm,剪切波传播方向与肌纤维夹角为0°、30°、60°、90°时,剪切波传播速度差异均有统计学意义(P均<0.05)。分别取剪切波方向与人体肌纤维排列的夹角为0°、30°、60°、90°时,不同深度剪切波传播速度差异无统计学意义(P均>0.05)。结论 探头扫查平面与肌纤维走行方向夹角影响剪切波的传播速度,深度相同时,随着剪切波传播方向与人体肌纤维排列方向夹角增大,剪切波速度有递减趋势。传播方向一致时,剪切波在人体肱二头肌中的传播速度与深度无明显关系。     

运动针刺鱼肩穴治疗肱二头肌长头腱鞘炎32例

对32例肱二头肌长头腱鞘炎患者行运动针刺鱼肩穴治疗,此穴治疗肱二头肌长头腱鞘炎疗效颇佳,再配合运动针法,以远处穴位疏导配以疼痛部位运动,边针刺边活动肩部关节,则更有利于经气的疏通及气血的运行,以达引其气血运行通畅而痛止。值得临床推广与应用。     

改良肱三头肌劈开入路在肱骨远端关节内骨折中的应用

目的探讨改良肱三头肌劈开入路在肱骨远端关节内骨折治疗的应用效果。方法肱骨远端关节内骨折41例,均采用改良肱三头肌劈开入路,手术复位固定骨折。结果本组41例均获随访,平均10.5(7~21)个月。骨折愈合时间平均为15.5周。按照Jup iter评分系统评价肘关节功能:优10例,良21例,可8例,差2例;功能优良率为75.6%。2例术后5个月发现骨折延迟愈合,1例术后8个月发现骨不连,其中2例经自体髂骨植骨后骨折愈合,1例发生肘关节严重僵硬放弃治疗。2例出现肘关节骨化性肌炎,但肘关节伸屈活动尚可。在术前无尺神经损伤的患者中,术后有2例早期出现环小指麻木,但手指活动正常,经对症处理术后1~3个月时症状消失;1例于术后3个月时开始出现环小指麻木、手指无力的尺神经损伤表现,术后7个月取出内固定物同时行尺神经前移术,症状基本消失。结论改良肱三头肌劈开入路不损伤尺骨关节软骨面及尺神经,手术创伤小,能满足肘关节早期功能锻炼的要求,是治疗肱骨远端关节内骨折一种较好的手术显露方法。     

Improving the repeatability of Motor Unit Number Index (MUNIX) by introducing additional epochs at low contraction levels

Objective

To evaluate the repeatability of (Motor Unit Number Index) MUNIX under repeatability conditions, specify the origin of variations and provide strategies for quality control.

Four-headed biceps and triceps brachii muscles,with neurovascular variation

Anatomical variations of the biceps brachii and triceps brachii have been described by various authors, but the occurrence of four-headed biceps brachii and triceps brachii in an ipsilateral arm is rare and has not been reported before in the literature. During routine cadaveric dissection in the department of anatomy, Kasturba Medical College, Mangalore, India, various unusual variants were noted in the left arm of a cadaver of a 67-year-old man. The variants include a four-headed biceps, a four-headed triceps, communication between the musculocutaneous and median nerves, and a high origin of deep brachial artery from the axillary artery. The occurrence of these anomalies and the clinical and morphological significance are discussed.     

Impulse conduction velocities in human biceps brachii muscles

Measurements of impulse conduction velocity were made in biceps brachii muscle fibers of male or female controls and of male body-builders. The technique involved exciting bundles of fibers with stimulating electrodes applied over the surface of the muscle, and recording compound action potentials with three small surface electrodes spaced 3 cm apart. By measuring latencies to the onsets and to the peaks of the negative deflections, it was possible to estimate conduction velocities in the fastest-conducting (FC) and intermediate-conducting (IC) fibers; the observed values ranged from 2.8 to 5.5 m·s⁻¹ in normal men and women. The mean conduction velocity for FC fibers was significantly higher in body-builders than in normal men and women; the mean IC value was significantly lower in women. In all three groups of subjects a decrease in conduction velocity could be demonstrated for FC fibers at the end of 1 min of maximal isometric contraction. In the body-builders, and probably in the other two groups of subjects, the FC fibers are considered to correspond to type II muscle fibers.     

Reinnervation of the biceps brachii muscle following cotransplantation of fetal spinal cord and autologous peripheral nerve into the injured cervical spinal cord of the adult rat

In order to compensate the loss of motoneurons resulting from severe spinal cord injury and to reestablish peripheral motor connectivity, solid pieces of fetal spinal cord, taken from embryonic day 14 rat embryos, were transplanted into unilateral aspiration lesions of the cervical spinal cord of adult rats. Concomitantly, one end of a 3.5-cm autologous peripheral nerve graft was put in close contact with the embryonic graft; the other end was sutured to the distal stump of the musculocutaneous nerve which innervate the biceps brachii muscle. The animals were examined 3 and 6 months after surgery. Following intramuscular injection of horseradish peroxidase, retrograde axonal labeling studies indicated that both transplanted and host spinal neurons were able to extend axons all the way through the peripheral nerve graft and nerve stump, up to the reconnected muscles. The labeled cells in the transplant were generally observed close to the intraspinal tip of the peripheral nerve graft. Retrograde axonal tracing, as well as electrophysiological and histological data, demonstrated the sensory and motor reinnervation of the reconnected muscles. This muscular reinnervation was able to reverse the atrophic changes observed in the denervated muscle. In control experiments, the extraspinal end of the peripheral nerve graft was ligatured in order to compare the differentiation of the transplanted neurons and the survival of their growing axons with or without their muscular targets. Six months after both types of surgery, large-size grafted neurons, identified as motoneurons by immunocytochemistry for peripherine and calcitonin gene-related peptide, were only observed in fetal spinal cord transplants which were connected to denervated muscles, thus demonstrating the trophic influence of the muscle target on the survival and differentiation of the transplanted neurons and on the maintenance of the axons they had grown into the peripheral nerve graft.