掌侧入路保留旋前方肌治疗桡骨远端不稳定骨折的解剖研究

外科研究与新技术 ›› 2015, Vol. 4 ›› Issue (1): 17-20.

掌侧入路保留旋前方肌治疗桡骨远端不稳定骨折的解剖研究

王炳¹,袁锋²

1. 上海第一人民医院宝山分院
2. 上海市同济医院骨科(创伤肿瘤)

收稿日期:2015-02-02 修回日期:2015-04-20 出版日期:2015-03-28 发布日期:2015-04-01
通讯作者: 袁锋 E-mail:yuanfengtj@outlook.com

An Anatomy Study of Reserving Pronator Quadratus in treating unstable Distal Radius Fractures via volar approach

Received:2015-02-02 Revised:2015-04-20 Online:2015-03-28 Published:2015-04-01

摘要/Abstract

摘要： 目的探讨掌侧入路并保留旋前方肌的钢板内固定技术治疗桡骨远端不稳定骨折的解剖基础。方法常规尸体解剖观察旋前方肌的形态、神经血管束的走行，毗邻关系,测量肌肉相关形态学指标，以及剥离旋前方肌远端附着后桡骨远端显露范围。结论该研究证实了掌侧入路保留旋前方肌的钢板内固定术治疗桡骨远端不稳定骨折的解剖基础以及其潜在的应用意义。

关键词: 旋前方肌, 桡骨远端骨折, 掌侧入路

Abstract: Objective To explore anatomic basis of reserving pronator quadratus(PQ) in treating unstable distal radius fractures via volar approach.Methods 18 human cadaveric forearms were used to dissected to observe and measure the morphologic features around the muscle,the distribution of pronator quadratus,the course of its neurovascular bundles and the length of the distal radius that can be exposed by mobilizing the distal edge of pronator quadratus from its radial attachment. Conclusion The study confirmed the anatomical basis and the potential apllied value of reserving pronator quadratus(PQ) in treating unstable distal radius fractures via volar approach.

Key words: pronator quadratus, distal radius fractures, volar approach

王炳袁锋. 掌侧入路保留旋前方肌治疗桡骨远端不稳定骨折的解剖研究[J]. 外科研究与新技术, 2015, 4(1): 17-20.

参考文献

[1] Chung K,Spilson S.The frequency and epidemiology of hand and forearm fractures in the United States[J].J Hand Surg Am,2001,26(5):908-915.
[2] Ismail AA, Pye SR,Cockerill WC,et al.Incidence of limb fracture across Europe:results from the European Prospective Osteoporosis Study (EPOS).Osteoporos Int.2002,13(7):565-571.
[3] Thomas PR,Richard EB,Christopher GM.骨折治疗的AO原则[M].2版.危杰等译.上海:上海科学技术出版社,2009:497.
[4] Park JH,Hagopian J,Ilyas AM.Variable-angle locking screw volar plating of distal radius fractures[J].Hand Clin. 2010,26(3):373-380.
[5] Henry MH,Griggs SM,Levaro F,et al.Volar approach to dorsal displaced fractures of the distal radius[J].Tech Hand Up Extrem Surg,2001,5（）:31-41．
[6]石展英,赵良军,李百川,等.单侧多功能组合架与锁定加压钢板治疗C型桡骨远端骨折的疗效分析[J].中华手外科杂志,2013,29(1):13-14.
[7]姜保国,张殿英,付中国,等.桡骨远端骨折的治疗建议[J].中华创伤骨科杂志,2010,12(11):1053-1056.
[8]田伟.实用骨科学[M].北京:人民卫生出版社,2008.423.
[9]文朝,潘会琴,王新,等.背侧双钢板与掌侧T型钢板治疗桡骨远端不稳定骨折的疗效比较.中华创伤骨科杂志[J].2012,14(12):1095-1097.
[10]吴卫东,朱晓东,蒋富贵,等.掌侧锁定加压接骨板治疗桡骨远端不稳定骨折[J].临床骨科杂志,2009,12(1):70-71.
[11]孙明宏.掌侧入路T型锁定钢板治疗老年挠骨远端骨折[J].实用骨科杂志,2009,15(6):442-443.
[12]Wright TW,HorodyskiM,Smith DW.Functional outcome of unstable distal radius fracture:ORIF with a volar fixed-angle tine plate versus external fixation.J Hand Surg(Am),2005,30(2):289.
[13]王少林,谭祖建,吴钢,等.桡骨远端不稳定骨折3种治疗方法疗效比较[J],临床骨科杂志，2011,14(3):316-318.
[14]唐涛,冯建璞,刘四海,等.掌侧入路治疗背侧移位的桡骨远端关节内骨折[J].中华外科杂志,2009,47(12):916-919．
[15]彭裕文.局部解剖学[M].北京:人民卫生出版社,2005:94-95．
[16]Stuart PR.Pronator quadratus revisited.J Hand Surg Br.1996,21（）:714-22.
[17]Ateschrang A,Stuby F,Werdin F,et al.Flexor tendon irri-tations after locked plate fixation of the distal radius with the 3.5 mm T-plate: identification of risk factors.Z Orthop Unfall.2010,148（）:319-25.
[18]Dellon AL,Mackinnon SE.The pronator quadrates muscle flap[J].J Hand Surg,1984,9A:423-427.
[19]钟桂子.带血管蒂旋前方肌骨膜骨瓣移位术[J].中国临床解剖学杂志,1988,6(4):235-237.
[20]Lee LC,Lim J,Chacha PB.The anatomical basis of the vascularized pronator quadrates pedicled bone graft[J].J Hand Surg,1997,22(5):644-646.