冈盂切迹的解剖形态学测量及临床意义

doi:10.13418/j.issn.1001-165x.2019.03.002

中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (3): 245-248.doi: 10.13418/j.issn.1001-165x.2019.03.002

冈盂切迹的解剖形态学测量及临床意义

赵虹瑾¹，　刘洋^{2, 3}，　李静^{2, 3}，　张磊^{2, 3}

1. 中国人民解放军联勤保障部队第九二〇医院，昆明 650032； 2. 西南医科大学附属中医医院，四川泸州 646000
3. 泸州市院士工作站，四川泸州 646000

收稿日期:2018-11-30 出版日期:2019-05-25 发布日期:2019-06-13
通讯作者: 张磊，主治医师，博士研究生，E-mail：307501597@qq.com E-mail:307501597@qq.com
作者简介:赵虹瑾（1977-），男，四川泸州人，主治医师，研究方向：骨关节的基础和临床研究，E-mail：zhj13888796387@163.com
基金资助:
泸州市院士工作站在建项目（20180101）；2018年度校级大学生创新创业训练计划项目（2018193）；2018年度省级大学生创新创业训练计划项目（201816032088）；2018年度国家级大学生创新创业训练计划项目（201816032088）

Anatomic measurement of the spinoglenoid notch and analysis of its clinical significance

ZHAO Hong-jin¹, LIU Yang^{2, 3}, LI Jing^{2, 3}, ZHANG Lei^{2, 3}

1. The PLA Joint Logistics Support Force 920th Hospital, Kunming 650032; 2. Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province; 3. Academician Workstation in Luzhou, Luzhou 646600, Sichuan Province, China

Received:2018-11-30 Online:2019-05-25 Published:2019-06-13

摘要/Abstract

摘要： 目的　探讨干燥标本的冈盂切迹解剖形态学测量及其临床意义。方法　收集282例干燥肩胛骨标本，观测冈盂切迹宽度（关节盂内侧缘至肩胛冈直线距离）、冈盂切迹厚度（冈盂切迹最低点厚度）、冈盂切迹深度、冈盂切迹转折角（肩胛切迹，冈盂切迹最低点连线与肩胛冈基底部所成的夹角）等。结果　冈盂切迹宽度、深度分别为（12.75±1.06）mm、（11.65±1.89）mm，且右侧更宽更深，双侧对比P<0.05有统计学差异；冈盂切迹厚度（9.93±1.57）mm，肩胛上切迹至冈盂切迹距离为（18.73±3.18）mm，且双侧对比P>0.05；冈盂切迹转折角为（40.24±8.69）°，双侧对比P<0.05有统计学差异。结论　冈盂切迹的厚度、深度、宽度和转折角均是肩胛上神经卡压症的危险因素，且冈盂切迹越深，冈盂切迹转折角越小，发生肩胛上神经卡压的几率越大。本研究解剖数据可为临床在手术入路和内固定物植入位置选择等提供参考，降低术中神经损伤风险。

关键词: 冈盂切迹, 　肩胛上神经卡压, 　解剖形态学, 　骨折

Abstract: Objective　To investigate the anatomic morphology and clinical significance of the spinoglenoid notch based on dry scapular bones.　Methods　In a total of 282 scapular bones (left 134, right 148), the following data were measured using Vernier caliper and Goniometer: the width of spinoglenoid notch (the distance from medial aspect of the glenoid to the scapular), the thickness of the spinoglenoid notch (the thickness of the nadir of the spinoglenoid notch), the depth of spinoglenoid notch, the angles of the spinoglenoid notch. 　Results　The average width and depth of the spinoglenoid notch were (12.75±1.06) mm and (11.65±1.89) mm. There was statistical difference between the two sides of body (P<0.05). The average thickness of spinoglenoid notch was (9.93±1.57) mm. The distance from the spinoglenoid notch to the suprascapular notch was (18.73±3.18) mm (P>0.05). There was statistical difference of the angles of the spinoglenoid notch between the two sides of body (40.24±8.69) (P<0.05).　Conclusion　The width, thickness and depth of the spinoglenoid notch are all the risk factors contributing to the suprascapular nerve entrapment syndrome. The smaller the angles of the spinoglenoid notch, the greater the chance of scapular nerve compression. The data presented in this study can provide a reference for clinicians to choose the best surgical approach and the internal fixation site to reduce the risk of intraoperative nerve injury, thus minimizing intraoperative risks.

Key words: Spinoglenoid notch, 　Suprascapular nerve, 　Anatomic morphology, 　Fracture

中图分类号:

R323.42

赵虹瑾, 刘洋, 李静, 张磊. 冈盂切迹的解剖形态学测量及临床意义[J]. 中国临床解剖学杂志, 2019, 37(3): 245-248.

ZHAO Hong-jin, LIU Yang, LI Jing, ZHANG Lei. Anatomic measurement of the spinoglenoid notch and analysis of its clinical significance[J]. Chinese Journal of Clinical Anatomy, 2019, 37(3): 245-248.

参考文献 28

[1]	Łabętowicz P, Synder M, Wojciechowski M, et al. Protective and predisposing morphological factors in suprascapular nerve entrapment syndrome: a fundamental review based on recent observations[J]. Biomed Res Int, 2017, 2017: 4659761.
[2]	Pecina M. Who really first described and explained the suprascapular nerve entrapment syndrome[J]. J Bone Joint Surg Am, 2001, 83-A(8): 1273-1274.
[3]	Zehetgruber H, Noske H, Lang T, et a1. Suprascapular nerve entrapment. A meta-analysis[J]. Int Orthop, 2002, 26(6): 339-343.
[4]	Holzgraefe M, Kukowski B, Eggert S, et a1. Prevalence of latent and manifest suprascapular neuropathy in high-performance volleyball players[J]. Br J Sports Med, 1994, 28(3): 177-179.
[5]	Kopell HP, Thompson WA. Pain and the frozen shoulder[J]. Surg Gynecol Obstet, 1959, 109(1): 92-96.
[6]	Agrawal D, Singh B, Dixit SG, et al. Morphometry and variations of the human suprascapular notch[J]. Morphologie, 2015, 99(327): 132-140.
[7]	Zhang L, Wei HR, Guo XG, et al. Variable morphology of the suprascapular notch: a proposal for classiﬁcation in Chinese population[J]. Ann Anat, 2018, 221: 173-178.
[8]	朱盛修. 肩胛上切迹与肩胛上神经嵌压症的解剖学基础[J]. 中国临床解剖学杂志, 1992, 10(3):199.
[9]	Momaya AM, Kwapisz A, Choate WS, et al. Clinical outcomes of suprascapular nerve decompression: a systematic review[J]. J Shoulder Elbow Surg, 2018, 27(1): 172-180.
[10]	Ganzhorn RW, Hocker JT, Horowitz M, et al. Suprascapular nerve entrapment[J]. J Bone Joint Surg Am, 1981, 63(3):492-494.
[11]	Loirat MA, Tierny M, Hervé A, et al. A new approach for endoscopic neurolysis of the suprascapular nerve at the spinoglenoid notch: a preliminary cadaver study[J]. Orthop Traumatol Surg Res, 2017, 103(6):861-864.
[12]	Mall NA, Hammond JE, Lenart BA, et al. Suprascapular nerve entrapment isolated to the spinoglenoid notch: surgical technique and results of open decompression[J]. J Shoulder Elbow Surg, 2013, 22(11): e1-e8.
[13]	Titelbaum AR, Ibarra Asencios B, McNeil BE. A circular depression at the spinoglenoid notch of a prehistoric Andean scapula: plausible evidence of suprascapular nerve entrapment by a paralabral cyst[J]. Int J Paleopathol, 2018, 24: 19-24.
[14]	Boerger TO, Limb D. Suprascapular nerve injury at the spinoglenoid notch after glenoid neck fracture[J]. J Shoulder Elbow Surg, 2000, 9(3): 236-237.
[15]	Vorster W, Lange CP, Briët RJ, et al. The sensory branch distribution of the suprascapular nerve: an anatomic study[J]. J Shoulder Elbow Surg, 2008, 17(3): 500-502.
[16]	Ebraheim NA, Whitehead JL, Alla SR, et al. The suprascapular nerve and its articular branch to the acromioclavicular joint: an anatomic study[J]. J Shoulder Elbow Surg, 2011, 20(2): e13-e17.
[17]	Plancher KD, Peterson RK, Johnston JC, et al. The spinoglenoid ligament. Anatomy, morphology, and histological findings[J]. J Bone Joint Surg Am, 2005, 87(2): 361-365.
[18]	宋云骏, 王永为, 姜林鹤, 等. 肩胛上神经卡压机制的临床解剖学研究[J]. 中国临床解剖学杂志, 2015, 3(6): 623-626.
[19]	Podgórski M, Sibiński M, Majos A, et al. The suprascapular vein: a possible etiology for suprascapular nerve entrapment and risk of complication during procedures around the suprascapular foramen region[J]. Orthop Traumatol Surg Res, 2014, 100(5): 515-519.
[20]	Challoumas D, Dimitrakakis G. Insights into the epidemiology, aetiology and associations of infraspinatus atrophy in overhead athletes: a systematic review[J]. Sports Biomech, 2017, 16(3): 325-341.
[21]	Rizzello G, Longo UG, Trovato U, et al. Bilateral suprascapular nerve entrapment by ganglion cyst associated with superior labral lesion[J]. Open Orthop J, 2013, 7(1):129-132.
[22]	Sangam MR, Sarada Devi SS, Krupadanam K, et al, et al. A study on the morphology of the Suprascapular notch and its distance from the glenoid cavity[J]. J Clin Diagn Res, 2013, 7(2): 189-192.
[23]	Aiello I, Serra G, Traina GC, et al. Entrapment of the suprascapular nerve at the spinoglenoid notch[J]. Ann Neurol, 1982, 12(3): 314-316.
[24]	Moriggl B. Fundamentals, possibilities and limitations of sonography of osteofibrous tunnels in the shoulder area[J]. Ann Anat, 1997,179(4): 375-392.
[25]	Wu WT, Chang KV, Mezian K, et al. Basis of shoulder nerve entrapment syndrome: an ultrasonographic study exploring factors influencing cross-sectional area of the suprascapular nerve[J]. Front Neurol, 2018, 9: 902.
[26]	Burks R. To cyst or not to cyst: shoulder SLAP lesions with concomitant spinoglenoid notch ganglion cysts [J]. Arthroscopy, 2018, 34(7): 2254-2255.
[27]	Ticker JB, Djurasovic M, Strauch RJ, et al. The incidence of ganglion cysts and other variations in anatomy along the course of the suprascapular nerve[J]. J Shoulder and Elbow Surg, 1998, 7(5): 472-478.
[28]	Leschinger T, Hackl M, Buess E, et al. The risk of suprascapular and axillary nerve injury in reverse total shoulder arthroplasty: an anatomic study[J]. Injury, 2017, 48(10): 2042-2049.

冈盂切迹的解剖形态学测量及临床意义

Anatomic measurement of the spinoglenoid notch and analysis of its clinical significance

可视化

摘要/Abstract

引用本文

使用本文

参考文献 28

相关文章 13

Metrics

本文评价

推荐阅读 0

[1]	黄海, 欧阳钧. 内固定治疗成人股骨颈骨折的研究进展[J]. 中国临床解剖学杂志, 2023, 41(6): 751-753.
[2]	杨华, 向磊, 蒋红兵, 胡兵兵, 曾参军, 张彬, 刘伟. 改良腹直肌旁入路与改良Stoppa入路治疗髋臼骨折临床疗效比较[J]. 中国临床解剖学杂志, 2023, 41(5): 603-607.
[3]	常树森, 何春念, 陈伟, 周健, 张芳, 聂开瑜, 邓呈亮, 魏在荣. 旋股外侧动脉降支Flow-through皮瓣联合MIPPO于急诊胫腓骨Gustilo IIIC型骨折中的应用研究[J]. 中国临床解剖学杂志, 2022, 40(6): 733-737.
[4]	彭昌贵, 罗鹰, 蓝国湖, 李日旺, 袁志坤, 包国庆, 李旭明, 潘剑英. 股骨干骨折三维闭合复位器的研制与临床应用[J]. 中国临床解剖学杂志, 2022, 40(5): 605-609.
[5]	吴铭杰, 庄伟达, 郑杰, 李修往, 陈敏, 樊晓海, 吴家昌, 桑宏勋. 计算机导航系统辅助置入空心螺钉内固定术治疗股骨颈骨折[J]. 中国临床解剖学杂志, 2021, 39(4): 454-459.
[6]	余浩, 邓晚秋, 桑鹏, 刘毅. 基于CT三维重建的肩胛冈解剖形态学分型及其临床意义[J]. 中国临床解剖学杂志, 2021, 39(4): 415-419.
[7]	范辉, 陈代全, 张勤, 吴启龙, 施建兴, 高飞, 包其能, 伍维昌. 骨水泥封闭经皮克氏针外固定支架治疗第5掌骨颈骨折疗效[J]. 中国临床解剖学杂志, 2021, 39(1): 105-107.
[8]	吴耿,张振伟,张美超,李征. 钢板骨折区增加螺钉帽对胫骨骨折内固定影响的有限元分析[J]. 中国临床解剖学杂志, 2019, 37(2): 185-189.
[9]	郭晓光,关钛元,张磊,扶世杰,周鑫,刘刚,陈跃. 少阳生骨方对SD大鼠胫骨骨折断端18F-NaF分布的影响[J]. 中国临床解剖学杂志, 2018, 36(5): 545-550.
[10]	张磊,覃波,郭晓光,祁冀,徐燕笑,扶世杰. 肩胛下角的解剖形态学分型及临床意义[J]. 中国临床解剖学杂志, 2018, 36(2): 132-136.
[11]	许博文，张青松，安思琪，裴宝瑞，李浩，戴世龙，吴啸波. 髋臼前壁骨折模型的建立及不同内固定方式的生物力学稳定性比较[J]. 中国临床解剖学杂志, 2017, 35(4): 425-430.
[12]	张宜, 邓羽平, 王勉, 谭晋川, 欧阳汉斌, 黄文华. 基于3D偏差分析的成人桡骨远端解剖对称性研究[J]. 中国临床解剖学杂志, 2017, 35(4): 388-393.
[13]	何哲, 乔贵宾, 欧阳钧. 国人第3~7肋影像解剖学测量及其临床意义[J]. 中国临床解剖学杂志, 2015, 33(1): 33-36.