Grabski Milosz, McNamara Jennifer, Roper Darren, Warren-Smith Chris, Busschers Evita
Department of Clinical Veterinary Sciences, United Kingdom.
Centre for Comparative and Clinical Anatomy, School of Veterinary Sciences, University of Bristol, United Kingdom.
Vet Surg. 2016 May;45(4):523-8. doi: 10.1111/vsu.12474. Epub 2016 Apr 7.
To describe the volume and dimensions of the bicipital bursa and its position in relation to bony and soft tissue structures, in order to develop a novel medial synoviocentesis approach to the bicipital bursa.
Cadaveric study.
Adult equine cadaver limbs (n=19).
Bicipital bursa dimensions, volume, and relationship to bony structures were obtained from positive contrast computed tomography images after distension of the bursa (n=7). Following an intra-bursal injection of polyurethane resin, the bicipital bursa (n=4) was dissected and its relationship to soft tissue structures described. After computed tomography and dissection, a novel medial bicipital bursocentesis approach was investigated on intact cadavers (n=8).
Median (range) of measurements were: length 9.02 cm (8.48-9.45 cm); width 7.06 cm (6.71-8.01 cm); and volume 51 mL (45-58 mL). The medial aspect of the bicipital bursa was located at the junction of the subclavius and biceps muscles, which corresponds with the externally visible lateral pectoral sulcus. Needle insertion 5-10 mm craniolateral to the center of the lateral pectoral sulcus midway between the palpable distal aspect of the deltoid tuberosity and the cranial part of the greater tubercle was found to be a reliable landmark for the novel medial bursocentesis approach. This approach was successful in all cadavers.
The novel approach to the bicipital bursa provided access to the medial aspect of the bursa and is an alternative to the lateral approaches. Further validation in live horses is warranted to establish the safety and efficacy of this technique.
描述肱二头肌滑囊的容积、尺寸及其相对于骨骼和软组织结构的位置，以开发一种新的经内侧对肱二头肌滑囊进行滑膜穿刺的方法。
尸体研究。
成年马尸体的肢体（n = 19）。
在滑囊扩张后，从阳性对比计算机断层扫描图像中获取肱二头肌滑囊的尺寸、容积及其与骨骼结构的关系（n = 7）。在向滑囊内注射聚氨酯树脂后，对肱二头肌滑囊进行解剖（n = 4），并描述其与软组织结构的关系。在计算机断层扫描和解剖后，在完整的尸体上研究一种新的经内侧肱二头肌滑囊穿刺方法（n = 8）。
测量的中位数（范围）为：长度9.02 cm（8.48 - 9.45 cm）；宽度7.06 cm（6.71 - 8.01 cm）；容积51 mL（45 - 58 mL）。肱二头肌滑囊的内侧位于锁骨下肌和肱二头肌的交界处，与体表可见的胸外侧沟相对应。发现在胸外侧沟中心颅外侧5 - 10 mm处进针，进针点位于三角肌粗隆可触及的远端和大结节颅侧部分之间的中点，是新的经内侧滑囊穿刺方法的可靠标志。该方法在所有尸体上均成功。
这种新的肱二头肌滑囊穿刺方法可进入滑囊内侧，是外侧穿刺方法的一种替代方法。有必要在活马中进一步验证以确定该技术的安全性和有效性。
