肩锁关节解剖学研究和临床意义

目的研究肩锁关节骨性和静态稳定结构,为肩部手术提供详细形态学资料。方法对26例成人新鲜尸体标本进行解剖,观察肩锁关节解剖形态并测量相关骨性标志和韧带的形态学参数。结果锥状韧带和斜方韧带锁骨止点中心到锁骨远端距离分别为(43.67±6.30)mm和(25.25±3.06)mm,止点宽度分别为(16.92±4.25)mm和(10.33±1.32)mm。锥状韧带长度为(15.54±3.32)mm,角度为(-116.25±10.90)°;而斜方韧带长度为(9.63±2.28)mm,角度为(75.42±11.37)°。锥状韧带和斜方韧带喙突止点相距(8.96±3.00)mm,而锁骨止点距离(13.08±3.50)mm,两条韧带呈"V"形结构。结论本研究获得了肩锁关节及其周围组织的详细形态学参数,为该部位手术提供解剖学资料。进行锁骨远端手术时应避免损伤锥韧带和斜方韧带止点,切除锁骨远端应不超过10mm以避免损伤斜方韧带。行喙锁韧带重建时要注意重建其"V"形解剖结构,以更好恢复其生理功能。

Anatomy of the Acromioclavicular Joint and its Clinical Use

Objective To study the ligamentous and bony structure of the acromioclavicular joint to assist acromioclavicular reconstruction and clavicular surgery.Methods 26 adult fresh cadaveric human shoulders were dissected,and ligamentous and bony structures of the AC joint were measured and analyzed.Results The mean distance from lateral clavicle edge to conoid and trapezoid ligaments center was(43.67±6.30) mm and(25.5±3.06) mm,and their clavicle insertion width were(16.92±4.25) mm and(10.33±1.32) mm,respectively.The length of conid ligament was(15.54±3.32) mm,the angle was(-116.25±10.90)°.The axial length of trapezoid ligaments was(9.63±2.28) mm,the angle was(75.42±11.37)°.They showed a V-shaped structure.The distance from superior clavicle to inferior coracoid process was(36.75±3.25) mm.Conclusion Detail morphology data of acromioclavicular joint were given.It could be used intraoperatively for distal clavicle surgery and acromioclavicular joint reconstruction.We believed that resect the distal clavicle no more than 10 mm during AC joint reconstruction would leave the trapezoid ligament safe,and that rebuild the V-shaped structure of the coracoclavicular ligament is necessary to restore its original function.