目的 观察肘关节尺侧副韧带(UCL)的解剖学特征，对其后束(PB)进行解剖学分类，为肘关节精确解剖、韧带的外科修复提供参考依据。 方法 82例结构完整的人上肢标本，解剖UCL，观察PB的形态特征及变异，依据其与肘关节囊的关系划分类型；测量PB的长度、起点宽度、止点宽度等。 结果 (1)根据PB与肘关节囊的关系分为：①Ⅰ型：PB的前缘及后缘均位于关节囊表面，增厚并游离，呈独立型条带61%(50例)；此类型男性、女性PB的长度分别是(20.92±2.59) mm、(17.28±2.07) mm，二者具有显著性差异(P=0.000，t=5.531)；②Ⅱ型：PB的前缘与肘关节囊融合，后缘增厚游离16%(13例)；③Ⅲ型：PB的后缘与肘关节囊融合，前缘增厚游离18%(15例)；④Ⅳ型：PB的前缘、后缘均与肘关节囊融合，难以分辨5%(4例)。(2)男性PB以Ⅰ型与Ⅱ型较多，女性PBⅠ型与Ⅲ型较多，在类型构成方面具有显著性差异(c2=8.096，P=0.035)。 结论 本实验对PB的分型，是对UCL解剖结构的补充；PB呈Ⅱ~Ⅳ等类型可能是导致其变异的重要因素；处理PB损伤时应考虑性别差异，便于结构功能恢复。
Abstract
Objective To clarify the morphological features of the posterior bundle (PB) of the ulnar collateral ligament of the elbow joint, so as to provide reference for anatomy of elbow joint and surgical repairs of ligaments. Methods A total of 82 adult elbow joints were dissected and the characteristics of the PB were noted. The length, widths of the origin and insertion of the PB were measured with a vernier caliber. Results (1)The PB was divided into four types according to the relation with the elbow joint capsule: ① typeⅠ, the anterior and posterior edges were located on the surface of the capsule and could be separated as a single ligament in 61% of cases. There was significant difference in length between male (20.92±2.59) mm and female (17.28±2.07) mm in this type (P=0.000, t=5.531). ② typeⅡ, the anterior edge of PB was fused with elbow joint capsule, while the posterior edge was thickened and free in 16% of cases. ③ type Ⅲ, the posterior edge of PB was fused with elbow joint capsule, while the anterior edge was thickened and free in 18% of cases. ④ type Ⅳ, the anterior and posterior edges of PB could not be separated from the elbow joint capsule in 5% of cases. (2) Types Ⅰand Ⅱ were more commonly occurred in male, while types Ⅰand Ⅲ were observed in female frequently. There was significant difference in type composition (c2=8.096,P=0.035). Conclusions The new classification of the PB was proposed based on the supplement to the anatomy of UCL, which emphasized the relation with the joint capsule of the elbow TypeⅡ~Ⅳ of PB maybe an important factor causing morphological variation. Gender difference should be considered when treating PB injury, so as to facilitate structural and functional recovery.
关键词
尺侧副韧带 /
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后束 /
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变异 /
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应用解剖
Key words
Ulnar collateral ligament /
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Posterior bundle /
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Variation /
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Applied anatomy
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参考文献
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基金
济宁医学院2023年大学生创新训练计划项目(cx20 23171)
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