摘要
目的判断肩锁关节韧带在维持肩锁关节稳定方面的作用。方法选取12具经福尔马林常规处理的正常肩关节尸体标本,解剖分离、显露喙锁韧带(斜方韧带和锥形韧带)。观察斜方韧带和锥形韧带的起止点分布、外观形态及附着区,并测量斜方韧带及锥形韧带长度、锁骨附着区冠状位及矢状位的长度、最外侧点到锁骨远端的距离以及斜方韧带及锥形韧带冠状位及矢状位的夹角。随后将12具完整的肩关节标本随机分为A、B、C、D四组(n=3):A组保留完整的肩锁韧带,B组保留完整的喙锁韧带,C组保留完整的斜方韧带,D组保留完整的锥形韧带。使用电子万能力学试验机,以100 mm/min的载荷速度对标本韧带在垂直方向进行破坏性的静态拉伸力学测定,通过与生物力学试验机相连接的计算机记录并描画载荷-位移曲线,记录各韧带的断裂强度。结果锥形韧带及斜方韧带的平均长度分别为10.6、12.5 mm;锥形韧带锁骨附着区冠状位及矢状位的平均长度分别为13.4、5.8 mm。斜方韧带锁骨附着区冠状位及矢状位的平均长度分别为14.2、8.7 mm。锥形韧带及斜方韧带最外侧点到锁骨远端的平均距离分别为35.5、23.6 mm。锥形韧带在冠状位和矢状位的平均夹角分别为6.2°、11.3°。斜方韧带在冠状位及矢状位的平均夹角分别为38.7°、6.9°。肩锁韧带断裂拉力为(201.3±1.9)N,喙锁韧带断裂拉力为(374.6±1.2)N,斜方韧带断裂拉力(192.3±4.3)N,锥形韧带断裂拉力(345.7±1.1)N。结论锥形韧带、斜方韧带和肩锁韧带对维持肩锁关节稳定性的作用和贡献不同。肩锁关节解剖重建时,以锥形韧带的解剖重建更为重要,同时应尽可能一期修复肩锁韧带。
Objective To determine the role of acromioclavicular ligament in maintaining the stability of acromioclavicular joint.Methods In 12 cadaveric specimens of normal shoulder joint which had been routinely treated by formalin,the coracoclavicular ligaments(trapezium and conical ligaments)were dissected and exposed after soft tissue was removed from the surface.The distribution of the insertion and starting points,appearance and attachment area of the trapezium and conical ligaments were observed.The lengths of the 2 ligaments,the coronal and sagittal lengths of the clavicular attachment area,the distances from the most lateral point to the distal end of the clavicle,and the angles at the coronal and sagittal positions of the 2 ligaments were measured.Subsequently,the 12 cadaveric specimens were randomly divided into 4 groups(n=3).Group A retained the intact acromioclavicular ligament,group B the intact coracoclavicular ligament,group C the intact trapezium ligament and group D the intact conical ligament.In an electronic machine for versatile mechanical tests,a 100 mm/min load speed was applied for destructive static stretching of the ligament specimens in the vertical direction.The load-displacement curves were recorded and drawn by a computer in connection with the biomechanical testing machine.The rupture strengths of the 4 ligaments were recorded.Results The average lengths of the conical and trapezium ligaments were 10.6 mm and 12.5 mm,respectively.The coronal and sagittal lengths of the clavicular attachment area of the conical ligament averaged 13.4 mm and 5.8 mm,respectively.The coronal and sagittal lengths of the clavicular attachment area of the trapezium ligament averaged 14.2 mm and 8.7 mm,respectively.The distances from the most lateral points of the conical and trapezium ligaments to the distal clavicle averaged 35.5 mm and 23.6 mm,respectively.The average angles at the coronal and sagittal positions were 6.2°and 11.3°for the conical ligament and 38.7°and 6.9°for the trapezium ligament,respectively.
作者
王晨
杨娜
衡立松
樊伟
朱养均
张堃
宋哲
Wang Chen;Yang Na;Heng Lisong;Fan Wei;Zhu Yangjun;Zhang Kun;Song Zhe(Traumatic Orthopaedics Center,Red Cross Hospital Affiliated to Medical College,Xi'an Jiaotong University,Xi'an 710054,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2019年第11期986-990,共5页
Chinese Journal of Orthopaedic Trauma
基金
陕西省社会发展科技攻关项目(2015SF143)。
关键词
肩锁关节
解剖学
生物力学
喙锁韧带
肩锁韧带
Acromioclavicular joint
Anatomy
Biomechanics
Coracoid ligament
Acromioclavicular ligament
