肘部及前臂上段正中神经卡压综合征的临床解剖学研究

Clinical anatomical study of the entrapment syndrome of median nerve at elbow and proximal forearm

目的 探讨肘部正中神经卡压综合征的解剖学基础。方法 解剖观察50侧上肢标本。结果 肱二头肌腱膜与正中神经的关系有非覆盖型40侧(80％),部分覆盖型6侧(12％)和完全覆盖型4侧(8％)。旋前圆肌纤维桥斜过正中神经前方32侧(64％)。旋前圆肌肱骨头肌内有腱束8侧(成人,占18.6％),尺骨头浅面较厚筋膜47侧(94％)。指浅屈肌起始结构有联合腱弓型44侧(88％),纤维弓2侧型(4％)和腱束型4侧(8％)。结论 腱膜和较厚筋膜是卡压正中神经的解剖基础。

Objective To explore the anatomical basis of the entrapment syndrome of median nerve. Method The fifty embalmed limbs were dissected.Results In the relationships between lacertus fibrous and median nerve,there are non-covering type (40, in 80%),partial-covering (6,in 12%) and complete-covering (4, in 8%),Pronator teres fibrous bridges were seen in 32 limbs (64%). The obvious intramuscular tendinous bundles in the humeral heads were observed (adults 8, in 18.6%). The thickened fascia in the superficial layer of ulnar head was seen in 47 (94%). The structures of origin border between two heads of flexor digitorum superficialis have three types, that is, conjoined tendinous arch (44, in 88% ),fibrous arch (2, in 4%),intramuscular tendinous bundle (4, in 8%). Conclusion The aponeurosis and thickened fascia at elbow and upper segment of the forearm are the anatomic basis of median nerve entrapment.