正中神经掌皮支形态特点及其临床意义

The feature of the palmar cutaneous branch of the median nerve and its clinical significance

目的：为腕掌部手术避免损伤掌皮支提供解剖学基础。方法：在双目放大镜下对５０侧成人上肢正中神经掌皮支的来源、走行及分支进行解剖和观测。结果：５０侧均存在掌皮支，距离“Ｏ”点即远侧腕横纹４６．０ｍｍ处自正中神经桡侧发出，穿出前臂筋膜处距Ｏ点１９．６ｍｍ；穿出掌腱膜处距Ｏ点８．３ｍｍ。掌皮支长４８．５ｍｍ，起点宽１．２ｍｍ，距舟骨结节垂直距离８．２ｍｍ。掌皮支有３个分支的２８侧（５６．０％）；只有外侧支和中间支的１１侧（２２．０％）；只有内侧支和外侧支的４侧（８．０％）；只有外侧支的４侧（８．０％）；只有中间支的３侧（６．０％）。结论：掌皮支的来源、行程较恒定。腕掌部手术应尽量靠近尺侧，采取纵行切口，免伤掌皮支。

bjective:To provide anatomy basis for avoiding palmar cutaneous branch (PCB) injury during wrist and palmar operation.Methods:The origin,course and branches of the PCB were dissected and measured under binocular in 50 specimens.It originates from the radial side of the median nerve about 46.0 mm to the zero point (the distal wrist crease), perforates the antebrachial aponeurosis about 19.6 mm to the zero point,and emerges off the palmar facia 8.3 mm to the zero point.The length of the PCB is 48.5 mm, and is 1.2 mm in width at its origin.The vertical distance between the PCB and the tubercle of the scaphoid is 8.2 mm.In 28 specimens(56.0%) The PCB has 3 branches.Which has 2 branches in 15 specimens (30%) and l branch in 7 specimens.Conclusions:A longitudinal incision which locates on the ulnar side of wrist and palmar is designed on the operation to avoid PCB injury.