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[1]劉星,張俊杰,景亞軍,等.針刀治療橈骨莖突狹窄性腱鞘炎安全區(qū)域的解剖學(xué)研究[J].中醫(yī)正骨,2018,30(02):7-9/15.
　LIU Xing,ZHANG Junjie,JING Yajun,et al.Anatomical study on the safe zone of knife needle in treatment of stenosing tendovaginitis of radial styloid[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(02):7-9/15.
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針刀治療橈骨莖突狹窄性腱鞘炎安全區(qū)域的解剖學(xué)研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年02期
頁碼:
7-9/15
欄目:
基礎(chǔ)研究
出版日期:
2018-02-20

文章信息/Info

Title:
Anatomical study on the safe zone of knife needle in treatment of stenosing tendovaginitis of radial styloid
作者:
劉星1; 張俊杰1; 景亞軍2; 廖立青2; 維尼2
1.廣東省第二中醫(yī)院,廣東 廣州 510095; 2.南方醫(yī)科大學(xué),廣東 廣州 510515
Author(s):
LIU Xing1; ZHANG Junjie1; JING Yajun2; LIAO Liqing2; WEI Ni2
1.The Second Hospital of Traditional Chinese Medicine of Guangdong,Guangzhou 510095,Guangdong,China 2.Southern Medical University, Guangzhou 510515,Guangdong,China
關(guān)鍵詞:
De Quervain病;  腱嵌壓;  橈骨莖突;  橈神經(jīng);  橈動脈;  解剖學(xué);  小刀針
Keywords:
Keywords De Quervain disease;  tendon entrapment;  styloid process of radius;  radial nerve;  radial artery;  anatomy;  small knife needle
摘要:
目的:探討針刀治療橈骨莖突狹窄性腱鞘炎的安全區(qū)域。方法:選取20具成人尸體上肢標(biāo)本(左側(cè)8例,右側(cè)12例),剝離以橈骨莖突為中心的長10 cm、寬5 cm的皮膚,仔細(xì)分離橈神經(jīng)淺支、血管和腱鞘,找到橈骨莖突掌、背側(cè)骨嵴最高點。觀測橈骨莖突周圍橈神經(jīng)淺支和橈動脈的走行分布,并以橈骨莖突掌、背側(cè)骨嵴及其最高點為標(biāo)志,分別在橈骨莖突外側(cè)腱鞘淺面和橈骨莖突外側(cè)面骨溝處各劃定1個安全治療區(qū)域,測量并比較這2個安全治療區(qū)域的面積。結(jié)果:①橈骨莖突周圍橈神經(jīng)淺支的走行分布。在橈骨莖突根部,橈神經(jīng)淺支斜行于橈骨莖突外側(cè)腱鞘淺面,其主要分支數(shù)量為1～2支,且走行于橈骨莖突掌、背側(cè)骨嵴形成的骨溝之外,僅有部分細(xì)小分支覆蓋于橈骨莖突腱鞘淺面。20具標(biāo)本中,19具有2支橈神經(jīng)淺支分支走行于橈骨莖突掌、背側(cè)骨嵴形成的骨溝之外,1具有1支橈神經(jīng)淺支分支走行于橈骨莖突背側(cè)骨嵴之外。②橈骨莖突周圍橈動脈的走行分布。橈動脈在橈骨莖突根部沿著橈骨莖突掌側(cè)骨嵴的掌側(cè)面走行,到達(dá)橈骨莖突掌側(cè)骨嵴最高點,以30°±5°角折向拇短伸肌和拇長展肌腱鞘的內(nèi)側(cè),并斜行至手背。③安全治療區(qū)域。橈骨莖突腱鞘淺面安全治療區(qū)的面積大于橈骨莖突外側(cè)面骨溝安全治療區(qū)的面積[(303.04±38.63)mm2,(134.29±24.37)mm2,t=2.286,P=0.023]。結(jié)論:橈骨莖突掌、背側(cè)2條骨嵴之間,掌、背側(cè)骨嵴最高點連線以上,距離兩骨嵴最高點1 cm以內(nèi),是針刀治療橈骨莖突狹窄性腱鞘炎的安全區(qū)域。
Abstract:
ABSTRACT Objective:To explore the safe zone of knife needle in treatment of stenosing tendovaginitis of radial styloid.Methods:The cadaveric upper limb specimens(8 on the left and 12 on the right)of 20 adults were selected.A 10×5 cm skin centered on radial styloid was stripped and superficial branch of radial nerve,blood vessels and tendon sheath were separated to find out the highest points of palmar and dorsal bony crest of vadial styloid.The orientation and the distribution of superficial branch of radial nerve and radial artery around radial styloid were observed.The safe zones for treatment were delineated on the surface of lateral tendon sheath of vadial styloid and in the lateral bone groove of vadial styloid respectively by taking vadial styloid palmar,dorsal bone crest and their highest points as the anatomic landmark.The areas of the two safe zones for treatment were measured and compared with each other.Results:At the root of radial styloid,the superficial branch of radial nerve passed by the surface of lateral tendon sheath of radial styloid obliquely and its main 1-2 branchs ran outside the bone groove formed by palmar and dorsal bony crest of radial styloid,and only a few small branches passed by the surface of tendon sheath of radial styloid.Two subbranches of superficial branch of radial nerve in 19 specimens ran outside the bone groove formed by palmar and dorsal bony crest of radial styloid,and one subbranch of superficial branch of radial nerve in 1 specimen ran outside the dorsal bony crest of radial styloid.At the root of radial styloid,the radial artery ran along the palmar surface of palmar bony crest of radial styloid and reached the highest point of palmar bony crest of radial styloid,and then turned to the medial side of tendon sheath of extensor pollicis brevis and abductor pollicis longus at an angle of 30+/-5 degree and ran slantly until the opisthenar.The area of safe zone for treatment was larger on the surface of tendon sheath of radial styloid compared to lateral bone groove of radial styloid(303.04+/-38.63 vs 134.29+/-24.37 mm(2),t=2.286,P=0.023).Conclusion:The zone between palmar bony crest and dorsal bony crest of radial styloid,above the line from the highest point of palmar bony crest to the highest point of dorsal bony crest,and within 1 cm to the highest point of the two bony crests,was the safe zone for treatment of stenosing tendovaginitis of radial styloid by using knife needle.

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備注/Memo

備注/Memo:
基金項目:廣東省中醫(yī)藥局資助項目(20162012) 通訊作者:張俊杰 E-mail:[email protected]
更新日期/Last Update: 2018-07-02