中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (18): 3277-3280.doi: 10.3969/j.issn.1673-8225.2012.18.011

• 细胞与组织移植 cell and tissue transplantation • 上一篇    下一篇

腋窝入路桡神经肱三头肌支转位移植修复腋神经的应用解剖★

董华张，阮文武，刘  云，沙  轲   

  1. 广西医科大学第一附属医院创伤骨科手外科，广西壮族自治区南宁市  530021
  • 收稿日期:2011-12-14 修回日期:2011-12-24 出版日期:2012-04-29 发布日期:2012-04-29
  • 通讯作者: 沙轲，主任医师，广西医科大学第一附属医院创伤骨科手外科，广西壮族自治区南宁市 530021 shake68@ 126.com
  • 作者简介:董华张★，男，1983年生，广西壮族自治区贺州市人，广西医科大学在读硕士，主要从事周围神经损伤研究。dhz13481030034@163.com

Transferring and transplantation of brachial triceps branches of radial nerve through axillary access in repairing axillary nerve: An applied anatomical study 

Dong Hua-zhang, Ruan Wen-wu, Liu Yun, Sha Ke   

  1. Department of Hand Surgery and Orthopaedic Trauma, First Affiliated Hospital of Guangxi Medical University, Nanning  530021, Guangxi Zhuang Autonomous Region, China
  • Received:2011-12-14 Revised:2011-12-24 Online:2012-04-29 Published:2012-04-29
  • Contact: Sha Ke, Chief physician, Department of Hand Surgery and Orthopaedic Trauma, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China shake68@126.com
  • About author:Dong Hua-zhang★, Studying for master’s degree, Department of Hand Surgery and Orthopaedic Trauma, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China dhz13481030034@ 163.com

PDF

331

被引次数

3

摘要：

背景：上臂后上切口入路肱三头肌肌支转位移植修复腋神经牵拉三角肌时易损伤腋神经后支及锁骨上臂丛，探查和联合其他神经转位时需变更体位。
目的：分析腋窝入路桡神经肱三头肌支转位移植修复腋神经的可行性。
方法：取常规甲醛固定成人上肢标本10具20侧，于标本平卧，上肢外展外旋位，腋窝入路，对腋窝处神经血管进行显微解剖。测量腋神经起始处至分支处距离及其分支起始处的横径，肱三头肌各肌支起始处横径，各肌支由入肌点向近端进行无损伤分离长度。
结果与结论：腋神经肩胛下肌下缘分成前后两支，前支横径平均为2.5(1.6~3.4) mm。桡神经肱三头肌长头支，起点处横径为2.2(1.4-2.8) mm。桡神经与腋神经距离平均为18.2(10.2~30.0) mm。腋神经前支与桡神经肱三头肌支横径相似，距离短。表明腋窝入路可暴露和辨别腋神经前后分支，桡神经肱三头肌支在背阔肌腱表面水平靠近腋神经，可选择任一肌支转位移植修复腋神经。
 

关键词: 腋神经, 移植, 臂丛神经, 神经转位, 桡神经

Abstract:

BACKGROUND: The posterior approach for axillary nerve by brachial triceps branches of radial nerve transfer produces excessive retraction of the deltoid muscle and may result in the injury to the posterior branch of the axillary nerve and supraclavicular brachial plexus, it required to change the location when explore and joint other nerve transfer. 
OBJECTIVE: To investigate the anatomical feasibility of transferring the brachial triceps branches of radial nerve to anterior branch of axillary through an axillary access in repairing axillary nerve.
METHODS: The axillary nerve was bilaterally dissected in 10 embalmed cadavers by conventional formaldehyde to study its variations. Dissection was performed through an axillary exposure with the supine, arm abducted and externally rotated and axillary access. All the nerves and vessels in the axilla were performed with microdissection. The distance from originating point to branch and transverse diameter of the anterior branch of axillary nerve were observed and measured. The transverse diameter of the anterior branch of the brachial triceps and the length of untraumatic detachment of brachial triceps branches of radial nerve were observed and measured.
RESULTS AND CONCLUSION: At the lateral margin of the subscapularis muscle, the axillary nerve was divided into an anterior and a posterior branch. The anterior branch diameter averaged 2.5 mm (range 1.6-3.4 mm). The triceps long head motor branch diameter averaged 2.2 mm (range 1.4-2.8 mm). The average distance between axillary nerve and radial nerve was 18.2 mm (range 10.2-30.0 mm). The diameter of triceps brachii branches of radial nerve was similar to the anterior branch of axillary nerves and the distance was short. It indicates that axillary access can expose and identify the anterior and posterior branch of axillary nerve. The axillary nerve can be repaired by triceps motor nerve transfer as the expression of brachial triceps branches of radial nerve on the surface of latissimus dorsi tendon was close to axillary nerve.

中图分类号: