目的 观察肱三头肌腱膜（Triceps aponeurosis, TA）的解剖学特征，并对其划分解剖学类型；分析TA与桡神经（Radial nerve, RN）的关系，为肱骨手术定位RN提供参考依据。 方法 63例结构完整的成人上肢标本，解剖并观察TA的解剖学类型，测量TA的长度和宽度；分别测量TA近端、外侧缘与RN的距离。 结果 （1）根据TA的形态，分为下列解剖学类型：①经典型：TA有1个近端尖和1个远端尖49例（77.8%）；②单尖型：TA仅有1个近端5例（7.9%）；③三尖型：TA有2个近端尖和1个远端尖6例（9.5%）；④阶梯型：TA呈阶梯形3例（4.8%）。（2） 男、女性TA的长度（P<0.05）与宽度（P<0.05）比较，差异均有统计学意义（P<0.05）；四类型之间TA的长度（P<0.05），以及RN距TA外侧缘的长度（P<0.05）比较，差异均有统计学意义（P<0.05）。 结论 对TA的解剖学分型，是对既往研究的补充。分析TA与RN之间的关系，可以更加准确地定位桡神经，为减少医源性神经损伤，提供良好的基础资料。
Abstract
Objective To observe the anatomical characteristics of the triceps aponeurosis (TA) and explore the relationship between TA and radial nerve (RN), so as to provide useful information for the localization of RN during humeral fracture surgeries. Methods A total of 63 adult upper limbs were dissected and the characteristics of the TA were noted. The length and width of the TA, the distance from the proximal apex and lateral border of the TA to the RN were measured, respectively. Results (1) TA was divided into the following 4 anatomical types according to its morphology: ①Classical type: TA had a proximal apex and a distal apex in 49 cases (77.8%); ②Single apex type: TA had only one proximal apex and no distal apex in 5 cases (7.9%); ③Three apexes type: TA had two proximal apexes and one distal apex in 6 cases (9.5%); ④Step type: TA showed a stepwise shape in 3 cases (4.8%). (2) There were significant differences in the length (P<0.05) and width (P<0.05) of TA between genders. There were significant differences in the length (P<0.05) of TA, and the distance between RN and the lateral edge of TA (P<0.05) in the four types. Conclusions The anatomical classification of TA is a supplement to previous studies. Analyzing the relationship between TA and RN can more accurately locate the radial nerve, providing positive reference when performing surgical procedures on humeral fractures.
关键词
肱三头肌腱膜 /
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变异 /
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桡神经 /
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肱骨骨折 /
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应用解剖
Key words
Triceps aponeurosis /
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Variation /
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Radial nerve /
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Humeral fractures /
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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2024年大学生创新训练计划项目（cx2024517py）
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