成人骨间前神经及其肌支的应用解剖

Applied anatomy of adult anterior interosseous nerve and its muscular branches

目的:观察成人骨间前神经及其肢支的解剖特点,为手术治疗骨间前神经卡压综合征及修复正中神经和尺神经损伤提供形态学依据。方法:解剖剥离30侧(左右各15侧)成人上肢标本,在测量骨间前神经及其肌支长度、径线等基本解剖学数据的同时,肉眼重点观察骨间前神经及其肌支在前臂的位置百分比。结果:骨间前神经于肱骨髁间连线下方(45.7±10.5)mm处起自正中神经,于肱骨髁间连线下方(79.06±7.49)mm处发出肌支,其在前臂的位置为13.2%～32.8%。拇长屈肌支(93.3%)和旋前方肌支(100%)以1支型、指深屈肌支(86.7%)以4支型出现率最多。骨间前神经发出的肌支主要位于前臂的27.6%～88.1%,其中拇长屈肌支为27.6%～48.3%,指深屈肌支为32.8%～49.9%,旋前方肌支为41.3%～88.1%。结论:测量并总结得出的有关手术治疗骨间前神经卡压综合征及修复正中神经和尺神经损伤的解剖学数据和定位方法有助于提高操作的准确性和安全性。

Objective To study the anatomy of adult anterior interosseous nerve and its muscular branches and provide the morphological basis for the surgical treatment of the anterior interosseous nerve syndrome and repair of the median nerve and ulnar nerve.Methods By the method of the anatomical dissection,the location of the anterior interosseous nerve and its muscular branches in the forearm from 30 upper extremities of adult cadavers were observed with visual inspection especially while its basic anatomical data such as length and diameter were measured.Results The anterior interosseous nerve arose from the median nerve（45.7±10.5）mm and gave off the muscular branches（79.06±7.49）mm below the line between the medial and lateral epicondyles of humerus.It was located in 13.2%-32.8% of the forearm.The number of the branches to the flexor pollicis longus（FPL,93.3%） and pronator quadrates（PQ,100%） was 1,the number of the branches to the flexor digitorum profundus（FDP,86.7%） was 4.The muscular branches of the anterior interosseous nerve were mainly located in 27.6%-88.1% of the forearm.The branches to FPL was located in 27.6%-48.3%;the branches to FDP was located in 32.8%-49.9%;the branches to PQ was located in 41.3%-88.1%.Conclusion This study may provide the anatomical basis for the surgical treatment of the anterior interosseous nerve syndrome and repair of the median nerve and ulnar nerve.The relative data and location method provided in this study are helpful to improve the accuracy and security of operation.