肩关节手术入路中的应用解剖学研究

目的:观测肩关节的形态结构及周围结构的特点,为临床手术提供资料。方法:解剖观察20具成人肩关节周围肌肉及其血管神经等重要结构。结果:三角肌外侧部深面主要有横过骨肌肉之间的腋神经前支和旋肱后血管,后侧深部主要有冈上肌冈下肌、小圆肌、回边孔、三边孔及其内部结构。(2)冈上肌肌腱密切粘着于肩关节囊例上部肌腱表面,于肩峰深面有肩峰下深液囊,有时与三角肌下滑液囊相通。(3)肩关节的血液供应主要靠旋肱前动脉及肩胛后动脉．肩关节靠近大血管主干,血供丰富、血流速度快。(4)神经界面,肩关节周围的界面有三角肌冈下肌间隙,三角肌胸大肌间隙,三角肌与喙肱肌、肱二头肌间隙、冈下肌小圆肌间隙。结论:肩关节结构极为复杂,解剖肩关节时应避免损伤重要组织结构。

Applied Anatomic Study of the Operative Approach to Shoulder Joint

Objective:To observe the morphologic structure of shoulder joint and peripheral tissues for a clinical study. Methods:twenty caverdes were dissected to make anatomic study of the important structure of shoulder joint,including peripheral muscles,vessels and nerves.Results:(1) Deep lateral part of deltoid mainly laid across anterior branch of axillary nerve and posterior humeral circumflex artery,crossing bones and muscles;deep posterior part laid supraspinatus muscle,infraspinous muscle,musculus teres minor,quadrilateral space,trilateral space and internal structures of them.(2)Supraspinatus tendon closely adhere with the surface of tendon of the Shoulder joint capsule.Synovial bursa under acromion underlay acromion,sometimes communicating with synovial bursa under deltoid.(3)Anterior humeral circumflex artery and posterior scapular artery are the main blood supply for shoulder joint,which is located near macro-vessels with rich blood supply and fast flow.(4)Nerve interface,The gap between deltoid and infraspinous musle,gap between deltoid and pectoralis major,the gap among deltoid,coracobrachial musle and biceps brachii,and the gap between infraspinous muscle and teres minor are existing in the interface of shoulder joint. Conclusion:The above results suggest that the structure of shoulder joint is very complicated and avoiding hurt vital structure is necessary.