肘关节尺侧副韧带

Atsuhiro Fukai, A. Nimura, M. Tsutsumi, Hitomi Fujishiro, K. Fujita, J. Imatani, K. Akita
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引用次数: 7

摘要

背景:为了提高肘关节外侧尺侧副韧带(LUCL)重建的临床效果,更好地了解腱膜和关节囊的解剖结构可能是相关的。本研究考虑了先前描述的LUCL与相关腱膜和关节囊的解剖关系,而不是作为离散韧带。我们假设浅表伸肌和旋后肌的深腱膜形成了关节囊的相关部分,之前定义为LUCL。方法:选取21具尸体(死亡年龄54 ~ 99岁)的24只肘部(右12只)作为研究对象。对20例肘部进行了宏观观察,4例进行了组织学观察。将关节囊与骨分离,用微计算机断层扫描(micro-CT)定量分析局部厚度。结果:旋后肌腱膜与关节囊混合形成一层厚膜(平均值和标准差为4.8±1.2 mm),我们称之为“囊膜-腱膜”。它比肱骨关节囊前部(1.3±0.4 mm)和后部(2.5±0.9 mm)厚(p < 0.001)。囊膜-腱膜广泛附着于肱骨趾共伸肌和指小伸肌(EDC/EDM)远端、冠突外侧和尺骨桡切迹后部。肱骨附着体为纤维软骨结构。EDC和尺腕伸肌(ECU)的深层腱膜连接到囊膜-腱膜。结论:髌腱膜由旋后肌腱膜和关节囊组成,附着于肱骨外侧上髁、冠突桡侧和尺骨桡侧切迹后部。整个结构与通常定义的外侧副韧带相同。最后方的部分连接到EDC和ECU腱膜,通常被标记为LUCL,但不存在离散韧带。临床意义:考虑囊膜-腱膜广泛附着的准确解剖,可以为LUCL重建技术和外侧上髁炎病理的改进提供有用的线索。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lateral Ulnar Collateral Ligament of the Elbow Joint
Background: To improve the clinical results of lateral ulnar collateral ligament (LUCL) reconstruction of the elbow joint, better understanding of the anatomy of the aponeuroses and joint capsule could be relevant. This study considers the previously described anatomy of the LUCL in relation to the related aponeuroses and joint capsule rather than as a discrete ligament. We hypothesized that the deep aponeuroses of the superficial extensor muscles and supinator form a relevant portion of the joint capsule previously defined as the LUCL. Methods: Twenty-four elbows (12 right) from 21 embalmed cadavers (age at the time of death, 54 to 99 years) were included in the study. Twenty elbows were studied macroscopically and 4, histologically. The joint capsule was detached from the bones, and local thickness was quantitatively analyzed using micro-computed tomography (micro-CT). Results: The supinator aponeurosis and joint capsule intermingled to form a thick membrane (mean and standard deviation, 4.8 ± 1.2 mm), which we termed “the capsulo-aponeurotic membrane.” It was thicker than the anterior (1.3 ± 0.4 mm) and posterior (2.5 ± 0.9 mm) parts of the capsule of the humeroradial joint (p < 0.001). The capsulo-aponeurotic membrane had a wide attachment on the distal part of the extensor digitorum communis and extensor digiti minimi (EDC/EDM) origin of the humerus, the lateral part of the coronoid process, and the posterior part of the radial notch of the ulna. The humeral attachment had a fibrocartilaginous structure. The deep aponeuroses of the EDC and extensor carpi ulnaris (ECU) were connected to the capsulo-aponeurotic membrane. Conclusions: The capsulo-aponeurotic membrane was composed of the supinator aponeurosis and joint capsule and was attached to the lateral epicondyle of the humerus, radial side of the coronoid process, and posterior part of the radial notch on the ulna. The entire structure appeared identical to the commonly defined lateral collateral ligament. The most posterior part was connected to the EDC and ECU aponeuroses, which is commonly labeled the LUCL but does not exist as a discrete ligament. Clinical Relevance: Consideration of the accurate anatomy of the extensive attachment of the capsulo-aponeurotic membrane could provide useful clues for improvement in techniques of LUCL reconstruction and lateral epicondylitis pathology.
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