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The anterior olecranon fracture-dislocation may resemble an ante rior Monteggia lesion in that there is anterior dislocation of the radial head with respect to the capitellum; however, the forearm remains intact and the injury is primarily to the ulnohumeral joint by means of disruption of the trochlear notch Figs.

前方鹰嘴骨折-脱位也有桡骨头相对于肱骨小头的向前的脱位,这点和孟氏骨折前方的病变情况有些一样,但它的尺桡关系没有破坏,主要是肱尺关节由于滑车切迹的撕脱而收到破坏的(图1A,1B)。

The save zone of muscle-splitting approach extends from the medial humeral epicondyle,and 2 cm beyond the end point of UCL on ulna.

经尺侧腕屈肌的肱头和尺头之间、自肱骨内侧髁向前外侧至UCL尺骨止点以远约2 cm为一损伤较小的安全手术入路。

Results About 55% of the force was transferred through the radial head when the elbow was in extension and the forearm in pronation. When the radial head was sectioned, the stress at the lateral aspect of the ulna- trochlea joint increased greatly than at the middle aspect.

结果经桡骨头传导的应力大小约占所施加应力的55%,桡骨头切除后,所施加的应力完全由肱尺关节承受,肱尺关节外侧关节面应力增加的幅度明显较内侧关节面大。

To observe and measure the distance and angulation of some muscles such as flexor carpi ulnaris,extensor carpi ulnaris , flexor carpi radialis,extensor carpi radialis longus,extensor carpi radialis brevis, brachioradialis,etc,we achieved the moment of force and loaded them in the model .

测量8具新鲜成人尸体的前臂主要肌肉和韧带横截面积,分别取其平均值,通过横截面积的肌力计算法,求得肌力和韧带力。主要肌肉为肱桡肌、桡侧腕长伸肌、桡侧腕短伸肌、尺侧腕伸肌、尺侧腕屈肌、桡侧腕屈肌等。测量的主要韧带为腕掌侧韧带、腕背侧韧带等。测量主要肌肉和韧带与坐标轴的夹角,求得分力值,然后直接或根据力矩等价原则间接地将肌力加载于模型体表各节点。

Results:The blood supply of medial arm cutaneous nerves origined from three cutaneous branch of intermuscular septa, which from superior ulnar collateral artery, brachial artery and inferior ulnar collateral artery.The mean diameters at the originated site were 1.0 mm, 0.6 mm and 0.7 mm.

结果:臂内侧皮神经的血供来自尺侧上副动脉肌间隔皮支、肱动脉肌间隔皮支和尺侧下副动脉肌间隔皮支,起始处外径分别为1.0 mm、0.6 mm和0.7 mm,穿出深筋膜前长为1.5 cm、1.1 cm和1.2 cm。

Results:The anterior bundle of the UCL starts from anterior inferior part of the medial condyle,and ends on the sublimis tubercle in front of the coronoid process of ulna,locating in the deep layer of the flexor carpal ulnar muscle.The distance between ulnar nerve and UCL is (0.9±0.1)cm in the center of cubital tunnel,and (0.6±0.3)cm in the distal foramen of cubital tunnel.The distance from the point of ulnar nerve entering the flexor carpi ulnar muscle to the medial epicondyle is (3.7±0.8)cm.The distance between the closest branch innervated flexor muscle of the median nerve and the approach is (1.6±0.5)cm at the level of medial epicondyle,and (0.9±0.4)cm at the level of ulnar tubercle.

结果:UCL前束起于肱骨内侧髁的前下方,止于尺骨冠突内侧的小结节,UCL前束位于尺侧腕屈肌肱头、尺头之间的深层;尺神经在肘管中部与尺侧副韧带前束的平均距离为(0.9±0.1)cm,在肘管的远侧出口,距尺侧副韧带的尺骨止点(0.6±0.3)cm;尺神经至尺侧腕屈肌尺头肌支的入肌点距肱骨内侧髁的距离为(3.7±0.8)cm;正中神经最靠近切口的分支距切口的距离,在肱骨内侧髁和尺骨结节水平分别为(1.6±0.5)cm和(0.9±0.4)cm。

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