«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:

01

期数:

2001年6期

页码:

349-351

栏目:

论著

出版日期:

2001-06-30

文章信息/Info

Title:

Endoscopic harvesting of the ulnar nerve in the forearm for the treatment of brachial plexus avulsion injury: anatomical study and clinical significance

作者:

官士兵　 史其林　 孙贵新　 顾玉东

上海复旦大学附属华山医院手外科,上海,200040

Author(s):

Guan Shibing;  Shi Qilin;  Sun Guixin;  et al.

Department ofHand Surgery, Huashan Hospital, Fudan University, Shanghai200040

关键词:

前臂; 尺神经; 臂丛; 解剖学研究

Keywords:

endoscope　　forearm　　ulnar nerve　　brachial plexus　　anatomical study

分类号:

R658

文献标志码:

A

摘要:

目的研究前臂部尺神经及其毗邻结构的解剖,为内镜下小切口切取前臂部尺神经移位治疗臂丛神经根性撕脱伤提供依据. 方法以6例福尔马林液固定的成人尸体上肢标本为对象,解剖前臂部尺神经及周围的毗邻结构,观察、测量及定位周围相关组织结构,设计入路及操作方法,并在6侧新鲜尸体标本上进行模拟手术. 结果尺神经在前臂部除肱骨内上髁下部穿经尺侧腕屈肌、远侧手背支穿尺侧腕屈肌和尺骨之间外,其他部分均行于肌间隙中,不再交叉穿经组织,与尺动脉伴行直至豆状骨水平,始终位于动脉的尺侧,与周围毗邻结构之间由疏松结缔组织相隔,易于分离.6次模拟手术均获成功. 结论前臂部尺神经解剖较恒定,行径中不与重要结构交叉,在豌豆骨上方和肱骨内上髁下方分别3～5cm处取1～2cm切口,直视下处理两处与肌肉交叉及主要分支后,其余部分与周围毗邻结构之间易于分离,故内镜下切取前臂部尺神经移位是安全可行的.

Abstract:

Objective　To study the ulnar nerve and its adjacent structures in the forearm and understand the anatomic basis for endo- scopic harvesting of the ulnar nerve forthe treatment of brachial plexus avulsion injury.　Methods　Ulnar nerves and their adjacent structures in 6 formaldehyde solution fixed upper limb specimen and 26 fresh upper limb specimenswere carefully dissected and observed and measured. The entry path and implementation were designed according to the observations. Simulated operation was performed in 6 fresh autopsy speci- mens　Results　In the forearm, ulnar nerve passes through the flexor carpi ulnaris under the medial epicondyle of the humerus and the dorsal branch of the hand passes between the ulnar bone and flexor carpi ulnaris. Also the ulnar nerve descends through intermuscular space, accom- paning the ulnar artery in the distant part of the forearm and the artery lies laterally along the nerve. The simulated operationswere successfully done in all the 6 specimens.　Conclusions　The anatomy of the ulnar nerve in the forearm is fairly fixed with no crossing with important structures in its path, incisions of 1~2cm are made above the pisiform bone and under the medial epicondyle of the humerus 3~5cm re- specitvely, After isolation of the ulnar nerve’s two crosses fromthe muscle, the remaining part of the ulnar nerve and its adjacent structures are easily dissected. It is concluded that it is safe and reliable to harvest the ulnar nerve in the forearm with endoscopy.

备注/Memo

备注/Memo:

基金项目：上海市医学领先学科基金(993015)资助项目

常用功能

更新日期/Last Update: 2014-09-26