前臂内侧及外侧皮神经移植的应用解剖

Applied Anatomy of Medial and Lateral Cutaneous Nerve Graft of the Forearm

目的 :为自体前臂内侧及前臂外侧皮神经移植提供解剖学基础。方法 :1 5具成人尸体 ,其中男 1 2具 ,女 3具共 30侧上肢 ,经锁骨下动脉灌注氨水稀释的红色乳胶后 ,进行大体解剖和观测。结果 :前臂内侧皮神经浅出点横经 2 4 7±0 5 0mm、长度 1 2 7 5 4± 4 1 1 7mm、浅出点距体表深度 8 70± 3 60mm ,主要分支有两条 ,前臂外侧皮神经浅出点横经 2 5 5±0 64mm、长度 5 4 5 1± 1 2 1 3mm、浅出点距体表深度 9 4 0± 2 4 0mm ,前臂外侧皮神经小动脉比前臂内侧丰富 ,但管径细小。寻找每条神经 ,都有两个可靠的手术部位。结论 :根据移植需要 ,可从最佳位置获取所需长度和横径的前臂内侧及外侧皮神经作移植供体 ,此二神经不适合带血管神经移植。

Objective:To provide anatomic basis for autologous lateral and medial cutaneous nerve graft of the forearm.Methods:Fifteen adult cadavers(12males and 3 females)were injected with red latex diluted by ammonia through subclavian artery,their 30 upper extremities were observed and measured.Results:The diameter and length of medial cutaneous nerve of forearm is2.47±0.50mm and 127.54±41.17mm respectively,the depth below the body surface is 8.780±3.60mm,the nerve has two main branches.The diameter and length of lateral cutaneous nerve of forearm is 2.55±0.64mm and 54.51±12.13mm respectively;the depth below the body surface is 9.40±2.40mm.There are two reliable place for harvesting each nerve.The small arteries were more abundant in lateral cutaneous nerve than that in medial.Conclusion:According to the need of nerve graft,from the most reliable place we can harvest forearm medial and lateral cutaneous nerve with desired length.The two nerves are not fit for vascularized nerve graft.