Desouky Ahmed Mohamed, Atiyya Ahmed Naeem, Elbishbishi Mohamed, Sawy Marwa Mohamed El
Department of Anatomy, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Orthopaedic, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Anat Cell Biol. 2023 Mar 31;56(1):39-45. doi: 10.5115/acb.22.201. Epub 2023 Feb 7.
Fixation of radial head fracture with minimally invasive posterior approach remains a significant challenge. The aim of this study was to determine the feasibility of trans-anconeus posterior elbow approach and to observe lateral ulnar collateral ligament (LUCL) in extended elbows. This cadaveric study was performed in twenty upper limbs of fresh fixed adult male cadavers. An oblique incision was made in the middle segment of anconeus until the lateral ligament complex and the joint capsule had been revealed. A deep dissection was explored to observe the anatomical relationship of the LUCL to the anconeus. Measurements of the LUCL were recorded while the elbow was fully extended. The mean distance between the edge of the radial head and the proximal insertion of the LUCL was 13.3 mm (11.5-16.2 mm); the mean distance between the edge of the radial head and the distal insertion of the LUCL was 20.9 mm (19.2-23.4 mm); the distance between the edge of the radial head and the distal edge of the annular ligament was 11.2 mm (8.22-11.7 mm). By estimate correlation of the previous measurements, the direct and accessible way to expose the posterolateral articular capsule of the elbow joint was through a window in medial 2/3 of the middle segment of anconeus muscle. These trans-anconeus approach is useful. It provides good visualization, facilitates applying the implants, and lessens the risk of radial nerve injury. Awareness of the anatomy is mandatory to avoid injury of LUCL.
采用微创后入路固定桡骨头骨折仍然是一项重大挑战。本研究的目的是确定经肘肌后入路的可行性，并观察伸直位肘关节的尺侧副韧带（LUCL）。本尸体研究在20具新鲜固定的成年男性尸体的上肢上进行。在肘肌中段做一个斜切口，直至显露外侧韧带复合体和关节囊。进行深入解剖以观察LUCL与肘肌的解剖关系。在肘关节完全伸直时记录LUCL的测量值。桡骨头边缘与LUCL近端附着点之间的平均距离为13.3毫米（11.5 - 16.2毫米）；桡骨头边缘与LUCL远端附着点之间的平均距离为20.9毫米（19.2 - 23.4毫米）；桡骨头边缘与环状韧带远端边缘之间的距离为11.2毫米（8.22 - 11.7毫米）。通过对先前测量值的相关性估计，暴露肘关节后外侧关节囊的直接且可及的方法是通过肘肌中段内侧2/3的一个窗口。这些经肘肌入路是有用的。它提供了良好的视野，便于植入物的应用，并降低了桡神经损伤的风险。必须了解解剖结构以避免损伤LUCL。
