Forthman Christopher L, Zimmerman Ryan M, Sullivan Michael J, Gabel Gerard T
Curtis National Hand Center, Baltimore, MD, USA.
J Shoulder Elbow Surg. 2008 May-Jun;17(3):522-6. doi: 10.1016/j.jse.2007.11.002. Epub 2008 Mar 6.
This study evaluated the insertional anatomy and orientation of the biceps tuberosity and tendon to assess the anatomic validity of repairs made with 1 incision vs 2 incisions. Computed axial tomography was used to image 30 cadaver radii, and each tendon insertion was measured with a digital micrometer. Specimens were sectioned and imaged with Faxitron radiography (Faxitron X-Ray Corp, Wheeling, IL) to determine the angular orientation of the biceps tendon insertion relative to the tuberosity apex. The tuberosity axis of orientation averaged 65 degrees (range, 15 degrees -120 degrees ) of pronation from anterior, with angular orientation encompassing a mean 59 degrees (range, 15 degrees -100 degrees ) arc with the midpoint of the insertion averaging 50 degrees (range, -5 degrees to 105 degrees ). Most biceps tendons inserted on the anterior aspect of the apex of the tuberosity, with an average width of 7 mm and length of 22 mm. The biceps tuberosity is oriented in more pronation than is typically described, prohibiting anatomic reinsertion of the tendon in 35% of specimens with current single-incision techniques.
本研究评估了肱二头肌结节及肌腱的插入解剖结构和方向，以评估单切口与双切口修复的解剖学有效性。使用计算机断层扫描对30个尸体桡骨进行成像，并使用数字千分尺测量每个肌腱插入点。对标本进行切片并用 Faxitron 射线照相术（Faxitron X-Ray 公司，伊利诺伊州惠灵）成像，以确定肱二头肌肌腱插入点相对于结节顶点的角度方向。结节的平均旋前方向轴从前侧起为65度（范围为15度至120度），角度方向围绕平均59度（范围为15度至100度）的弧度，插入点中点平均为50度（范围为 -5度至105度）。大多数肱二头肌肌腱插入结节顶点的前侧，平均宽度为7毫米，长度为22毫米。肱二头肌结节的旋前程度比通常描述的要大，采用当前的单切口技术，在35%的标本中无法进行肌腱的解剖学重新插入。
