桡神经肱三头肌长头支修复腋神经的解剖和临床应用

Neurotization from one of triceps branches of radial nerve to axillary nerve: clinical application and anatomy

目的 介绍用肱三头肌长头支转位修复腋神经的解剖学特点和临床应用效果。 方法 采用灌注成人尸体标本 16具 ,常规解剖显露腋神经和肱三头肌长头支 ,观察各神经支的毗邻关系 ,测量各神经支的横径。根据解剖学特点临床应用 6例 ,进行随访。 结果 肱三头肌长头支与腋神经相隔于长头本身 ,转位方便 ,其横径与腋神经前、后支横径相近 ,便于吻合。临床应用 6例 ,术后经随访6～ 16个月 ,M4以上肌力 5例 ,M3肌力 1例 ,伸肘无影响。 结论 桡神经肱三头肌长头支转位修复腋神经 ,术式简便 ,容易操作 ,适用于臂丛部分损伤。

Objective To introduce a new surgical procedure for the treatment of axillary nerve injury:neurotization from one of triceps branches of radial nerve to one of axillary branches Methods To study the anatomical relationship between the nerve branches to triceps and the axillary nerve branches to deltoid muscle by anatomical dissection as well as to measure the diameters of the nerve branches,and to complete the performance in clinic in six patients and follow up for 6～16 months Results The branches to long head of triceps of radial nerve were near to branches of axillary nerve and the difference among the nerve branches are little in diameter,and there were 5 patients who got M4 recovery of the muscle strength and 1 patient M3 Conclusion The new surgical procedure is easy to manipulate,with a satisfactory result,and is suitable for the partial brachial plexus injury patient with axillary nerve dysfunction but the radial nerve function formal