正中神经鱼际肌支功能束定位显微外科解剖

Microsurgery anatomy on functional tract location of thenar branch of median nerve

目的 :为臂丛损伤后正中神经及其手内在肌支的定位提供显微外科解剖学基础。方法 :在较新鲜的上肢标本上 ,按照自然分束、醋酸浸滴法逆行显微解剖分离各功能束组 ,分段观察手内肌束组在神经干中的走行分布方位和与其他功能束的交错混合情况。结果 :(1)正中神经鱼际肌支 83 %自神经干掌桡侧汇入 ,至 5 /16平面 86%的鱼际肌支已分散到神经干截面积的 1/2以上。 (2 )正中神经鱼际肌支汇入神经干平面距尺桡骨茎突连线之间距离为 5 .3± 0 .7cm。结论 :.臂丛损伤修复正中神经手内在肌支时 ,以选择在前臂远端 (或以远 )直接修复为宜。

Objective: To provide microanatomical basis for the location of median nerve and its intrinsic muscles branch after the damage of brachial plexus. Method: Twelve cadaveric upper extremities fixed recently by the formalin were obtained. The nerve specimens were infused topically with 10% acetic acid and individual fascicular groups was dissected by tracing their terminal branches. The arrangement and location of the fascicular group to the intrinsic muscles of hand in the nerve trunk were observed and recorded in each segment. It was observed that how it crossed and mixed with other fascicular groups. Results: Almost all the thenar muscles branches can be located at the radialis or palm-radialis trunk of the median nerve at the distal of 5/16 height. The distance from the point where it going out from the trunk to the line between styloid process of radius and styloid process of ulna was (5.3±0.7)cm. Conclusion: We should recover the intrinsic muscle 's function of hand by recovering thenar muscles branches in the distal arm of the patient who are suffering from nerve injury of brachial plexus when it is hopeless to do it at the proximal of the arm.