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中华肩肘外科电子杂志 ›› 2024, Vol. 12 ›› Issue (02) : 184 -189. doi: 10.3877/cma.j.issn.2095-5790.2024.02.015

综述

冈上肌/冈下肌足印区及其分界线的解剖学研究进展
白钜澄1, 崔国庆1,(), 邵振兴1,()   
  1. 1. 100080 北京大学第三医院运动医学科 北京大学运动医学研究所 运动医学关节伤病北京市重点实验室 运动创伤治疗技术与器械教育部工程研究中心
  • 收稿日期:2024-01-05 出版日期:2024-05-05
  • 通信作者: 崔国庆, 邵振兴

Anatomical research progress on the supraspinatus/infraspinatus footprint area and their dividing line

Jucheng Bai, Guoqing Cui(), Zhenxing Shao()   

  • Received:2024-01-05 Published:2024-05-05
  • Corresponding author: Guoqing Cui, Zhenxing Shao
引用本文:

白钜澄, 崔国庆, 邵振兴. 冈上肌/冈下肌足印区及其分界线的解剖学研究进展[J]. 中华肩肘外科电子杂志, 2024, 12(02): 184-189.

Jucheng Bai, Guoqing Cui, Zhenxing Shao. Anatomical research progress on the supraspinatus/infraspinatus footprint area and their dividing line[J]. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2024, 12(02): 184-189.

肩袖撕裂是一种常见的肩关节损伤,其中以冈上肌/冈下肌的撕裂最为常见,目前临床上对于肩袖撕裂的治疗关节镜手术修复是首选的治疗方法,而符合解剖结构的手术修复将有利于预后,冈上肌与冈下肌在的足印区及其分界线一直以来都存在争议,近年的解剖学研究也提出了一些新的观点,本文总结并讨论了传统及新的解剖学观点的差异,以及新的解剖学观点对肩袖撕裂修复产生的影响。

图1 传统观点肩袖肌肉足印区示意图 图A:传统观点的冈上肌与冈下肌足印区范围(后侧面图);图B:传统观点的冈上肌与冈下肌足印区范围(俯视图)注:图B蓝色部分为传统观点中冈上肌足印区为近似于梯形的区域;图B红色部分为冈下肌足印区
图2 冈上肌与冈下肌交叉附着示意图注:箭头指示为冈下肌与冈上肌的肌纤维走行方向;淡紫色区域为冈下肌和冈上肌在肱骨大结节足印区的交叉部分
图3 新观点肩袖肌肉足印区示意图 图A:新观点的冈上肌与冈下肌足印区范围(后侧面图);图B:新观点的冈上肌与冈下肌足印区范围(俯视图)注:图B蓝色区域为冈上肌足印区,其大致呈三角形;红色区域均为冈下肌足印区
表1 对比传统观点与新观点冈上肌与冈下肌附着区域范围(mm)
图4 侧印痕位置示意图 图A:新观点的印痕分布区域;图B:新观点印痕分布区域在骨骼的显示注:图A黑色三角形区域为侧印痕区域,其与左侧紫色区域共同组成冈下肌足印区,右侧三角形紫色区域为冈上肌足印区;图B骨骼标本上,绿色区域为侧印痕区域,其与左侧红色区域共同组成冈下肌足印区,其右侧三角形红色区域为冈上肌足印区
表2 印痕区域范围长度
图5 肩袖撕裂缝合过程中的后叶拉动方向
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