摘要
[目的]通过对肱骨中下段和桡神经的解剖观测,设计桡神经移位术。[方法]采用解剖学技术,对15具10%福尔马林固定的成人男性尸体30侧上肢桡神经的走行、分支,及与肱深血管的关系进行了解剖观察与测量,同时对100侧干燥肱骨的长度、桡神经沟长度及桡神经走行的角度(桡神经沟与肱骨纵轴夹角)进行观测。[结果](1)骨标本测量:肱骨长度左侧为(30.60±1.46)cm,右侧为(31.37±1.23)cm;桡神经沟长度左侧为(5.65±1.01)cm,右侧(6.57±0.58)cm。桡神经走行的角度左侧为13.00°±1.08;°右侧13.86°±0.97;°(2)尸体标本观察,桡神经走行中的角度:桡神经在桡神经沟内由内上斜向外下方,穿过外侧肌间隔后行向内下方,形成向内开放的钝角。角度明显29侧占96.67%;不明显1侧,占3.33%;(3)桡神经分为浅深支的位置:在肱骨内外上髁连线(髁间线)以上17例次,占76.67%;在髁间线以下10例次,占33.33%:平髁间线3例次,占10.00%;(4)从桡神经出口到桡神经分叉的距离(弧距)为(14.26±1.01)cm;(5)桡神经和相邻肱深血管的关系:桡神经在肱深血管内侧12例次,在肱深血管外侧10例次,和肱深血管相交叉8例次。[结论]桡神经移位术设计合理,符合桡神经的解剖生理,为肱骨中下段骨折进行各种内固定提供了更大的操作空间,减少了术中和术后取内固定时桡神经再损伤的发生,且不增加手术难度和损伤,是一种理想的术式。
A[ Objective] Through the anatomical observation and measurement on middle and distal humerus and radial nerve, To investigete a new radial nerve transfer operation. [ Method ] By means of anatomical methods, radial nerve′s stretching branch, the relationship between radial nerve and deep brachial vessel in 30 upper climbs were observed and measured on 15 adults fixed in 10% formalin. The anatomical structures of humerus of one hundred specimens were also observed. This data were made by designing and performing the radial transfer operation after statistical analyzing. [ Result] （ 1 ） Length of humerus： The left side was （30.60±1.46） cm and the right side （31.37±1.23） cm. The length of sulcus for radial nerve： the left side was （ 5.65±1.01 ） cm and the right side （6.57±0.58 ） cm. The stretch angle of radial nerve ： the left was 13.00°±1.08°, the right 13.86°±0.97° （2）The stretch angle of radial nerve： the radial nerve in the sulcus for radial nerve went from superomidial re- gion to lateral lower region and the angle open to the inner part was formed. The angle is obvious in 29 sides, that was 96.67%, and not obvious only in 1 side, that was 3.33%. （3）The position of the radial nerve superficial and deep branches： The radial nerve in 17 sides branches were above interepicondylar line, which was 76.67%. Below the line were 10 sides, cover 33.33% and on the line 3 sides, cover 10.00%. （4） The curve distance between the exit of radial nerve and the brarnches was （ 14.26±1.01 ） cm. （ 5 ） The relationship between radial nerve and deep brachial vessel ： the radial nerve lies inside of the deep brachial vessel were 12 sides, lies the outside of the deep brachial vessel were 10 sides and cross the deep brachial vessel were 8 sides. [ Conclusion] The design of radial nerve transfer operation is reasonable, it conforms to the radial nerve＇s anatomy and physiology and provides much wider operation space for the performing of all kinds of internal fixation on fractures of middle and distal humerus. It reduces the injury of the radial nerve in the course of the operation and alter the operation while taking the in- ternal fixation substance out. It doesnt increase the difficulty and injury.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第12期927-928,939,共3页
Orthopedic Journal of China
关键词
桡神经移位术
解剖学基础
radial nerve transfer operation
anatomical base
