成人正中神经与肌皮神经交通支的解剖学特征及其临床意义

Anatomical features and clinical significance of communicating branches between median nerve and musculocutaneous nerve in adults

目的观测成人正中神经与肌皮神经之间交通支的特征,为临床预防及修复神经损伤提供解剖学基础。方法随机选取90侧成人上肢标本,充分解剖暴露臂丛及其分支,观察并测量正中神经与肌皮神经之间交通支的起止点、长度、直径。结果90侧上肢中,24侧存在交通支,出现率26.7%。交通支长(66.49±39.35)mm,中点直径(1.23±0.62)mm,交通支起点距喙突距离为(149.78±32.43)mm。本研究观察到3种分型:Ⅰ型占33.3%(8/24),Ⅱ型占62.5%(15/24),Ⅲ型较少见(1/24)。交通支的出现率在性别间或侧别间均无显著差异。结论正中神经和肌皮神经之间的交通支并不少见,在臂部手术中应注意上述3种分型变异,以选择最佳术式。

Objective To observe the characteristics of communicating branches between median nerve and musculocutaneous nerve in adults,and to provide anatomical basis for clinical prevention and repair of nerve injury.Methods Ninety adult upper limb specimens were collected randomly for this study.The brachial plexuses and their branches were completely exposed.The starting and ending points,length and diameter of the communicating branches between the median nerve and the musculocutaneous nerve were observed and measured.Results Of the 90 upper limbs,24 had communicating branches,and the occurrence rate was 26.7%.The length of the branch was(66.49±39.35)mm,the mid-point diameter was(1.23±0.62)mm,and the distance between the starting point of the traffic branch and the beak was(149.78±32.43)mm.In this study,three types reported by Zengnaxin were observed:33.3%(8/24)of typeⅠ,62.5%(15/24)of typeⅡ,4.2%(1/24)of typeⅢ.In addition,there was no significant difference in the occurrence rate of communicating branches between different genders or between different sides.Conclusion The communicating branches between median and musculocutaneous nerves is not rate,and the above-mentioned three types of variantion should be noted in the operation of the arm for choosing the best operation.