正中神经环指桡侧指神经支移植修复尺神经深支缺损的应用解剖

The anatomical research of grafting ring finger radial digital branch of median nerve for repairing injuried deep branch of ulnar nerve defects

目的为研究环指桡侧指神经支移植修复尺神经深支缺损提供解剖学基础。方法对16例32侧新鲜成人上肢进行观测。在10倍手术显微镜下对腕部尺神经深支、正中神经旋前方肌支和环指桡侧指神经支进行显微解剖及测量。结果正中神经旋前方肌支直径为（1．13±0．02）mm，正中神经环指桡侧指神经支直径为（1．17±0．05）mm，对掌肌管出口处尺神经深支直径为（1．75±0．07）mm。显微镜下分离环指桡侧指神经支，对掌肌管出口处尺神经深支至旋前方肌支入肌长度即移植段神经长度为（104．59±20．25）mm。结论环指桡侧指神经支移植为带血运的神经移植，属肌支对肌支的吻合，是修复尺神经深支缺损的有效方法。

Objective To provide anatomical basis of neural transplantation to repair deep branch of ulnar nerve defect with the ring finger radial digital branch. Methods Thirty-two sides of 16 cases fresh forearms were dissected and observed. Microdisseet and measure the deep branch of ulnar nerve, quadrate pronator of median nerve and it＇s ring finger radial digital branch under lO-times operating microscope. Results The diameter of quadrate pronator of median nerve was （1.13 ± 0.02）mm, ring finger radial digital branch of median nerve was （1.17 ±0.05）mm, mid-palmar section of deep branch of ulnar nerve was（ 1.75 ± 0.07）mm. Dissect ring finger radial digital branch of median nerve to muscular branch of quadrate pronator under operating microscope, retaining it＇s blood supply. The length between the deep branch of ulnar nerve and ring finger radial digital branch was （104.59 ± 20.25 ）mm. Conclusion （1）Solving the problem of nerve grafting without blood supply before, benefit to the survival of the grafting segment and the regeneration of the neuro fiber, and function restoring.（2）This kind of grafting is the bridging of muscular branch to muscular branch, abide by the principle of neurophysiology. （3）Neural transplantation to repair deep branch of ulnar nerve defect with the ring finger radial digital branch is an effective method.