A Study Of Anatomy In Scalene Fissure

Objective: By systematic study of the position and length of scalenefissure, and intensive study of the organizations through scalene fissure, we canunderstand better about scalene fissure. It would offer guidance to clinical atdiagnosing and treating sclenus anticus syndrome.Materials and Methods：Use25Chinese adult anticorrosive conventionalcadavers perfused by20%formaldehyde solution, consisting of25male and10female. Appearance is not limb deformity, and necks are complete. Observeand measure the relevant data of anterior scalene muscle, scalene fissure andthe internal structures. Then process data with statistical software.Results:1、The distance between the upper corner of scalene fissure and themid-point of clavicle’s upper edge is (5.33±0.80)cm, the distance between theinner corner of scalene fissure and the sternum segment of the clavicle is(5.12±0.78)cm, the distance between the outer corner of scalene fissure and thesternum segment of the clavicle is (6.81±0.69)cm. The length of the inside edgeis (61.67±1.28)mm, the length of the outside edge is (57.62±1.37)mm, thelength of Lower bound is (8.98±1.97)mm.2、Anterior scalene muscle：the majority is from anterior tubercle of C3～6, end at the inside edge of the first rib and the scalene tubercle. The averagelength of anterior scalene muscle is (87.54±10.13)mm. The width at level, thetop of the scalene triangle, is (17.85±4.12)mm, the thickness is (9.53±2.37)mm;the width at level, the middle of the scalene triangle, is (14.39±2.67)mm, thethickness is (8.34±2.05)mm; the width at level, the top of the first rib, is(11.27±2.51)mm, the thickness is (7.70±1.91)mm. The width of anteriorscalene muscle in front of subclavian artery is (10.74±3.79)mm, the thickness is (5.86±2.25)mm; the width above subclavian artery is (12.32±3.57)mm, thethickness is (7.29±1.89)mm.3、The length of subclavian artery in scalene fissure is (11.56±2.13)mm,the diameter is (8.28±2.47)mm. The distance between subclavian artery and theupper edge of first rib is (5.86±0.43)mm, the distance between subclavianartery and lower trunks of brachial plexus is (2.07±0.33)mm.Conclusions:1、Sclenus anticus syndrome has the same symptoms as the other diseaseslike radicular cervical spondylosis. Therefore, in clinic we should be noted toboth clinical symptom and special inspections, and combined with CT or otherexaminations, to avoid misdiagnosis.2、In scalene removal surgery,We should cut at the superior of clavicle orunited the superior and inferior of clavicle.In the surgery we must cut down allthe reasons,which can constrict brachial plexus and blood vessels.During thesurgery we shuold not only cut down all the algesic reasons,but also pay ourattention to avoid the lower trunk of brachial plexus and subclavian artery.3、As a non-surgical treatment of sclenus anticus syndrome brachialplexus block is effective and feasible. The point where enter the needle shouldbe far away from the top of the first rib, to avoid subclavian artery.