摘要
目的测算尺神经分支的神经纤维数目和结缔组织面积等指标,计算各功能束组的纤维含量及比例,为临床选择性修复手内肌功能的手术设计和估计预后提供参考依据。方法新鲜尸体标本具,分离尺神经及其分支,各分支取材,福尔马林固定,常规石蜡横断面切片厚7μm,Loyez髓鞘染色法染色,应用图像分析系统对组织切片定量分析。测算各分支神经断面纤维密度、神经纤维截面积和神经干截面积,计算神经纤维数目,神经纤维和结缔组织所占比例。结果定量分析:尺神经分支有髓纤维总数为13648条,其中尺神经深支(支配手内肌)(3601±647)条,占26%;第四指间隙皮支(2327±609)条,占17%;小指尺侧皮支(2236±464)条,占16%;尺神经深支(支配手内肌)(3601±647)条,占26%;腕背支(2565±382)条,占19%;尺动脉支(418±210)条,占3%;尺侧腕屈肌远支(660±376)条,占5%;指深屈肌支(930±411)条,占7%;尺侧腕屈肌近支(914±223)条,占7%。结论手内肌功能束组是尺神经中最主要的功能束组,采用束膜缝合法选择性修复,将减少所需移位神经纤维的数目。
Objective To measure and calculate the number of nerve fibers, tissue surface area, and the fiber percentage of each functional branch so as to provide anatomical evidence for operation design of selective repair of intrinsic muscle function and estimate of prognosis in clinic. Methods 6 fresh cadaveric upper extremities were obtained, and the ulnar nerve and its branches were exposed. Specimens were got from each branch. All the specimens were fixed in formalin. The 7 μm thick routine waxed cross sections were made and stained according to the myelin technique of Loyez. The histological sections were analyzed by using IAS. For each branch, the density and section area of myelinated nerve fiber and area of the nerve trunk were measured and calculated. Then the number of myelinated nerve fibers, the proportion of nerve fibers and connective tissue were calculated. Results The results of quantitative analysis showed that the total number of myelinated fibers of the ulnar nerve was 13648, of which the deep divisions of the ulnar nerve (3601±647) accounted for 26%; the finger cutaneous branches of forth interspace (2327±609) accounted for 17%, the little finger ulnar cutaneous branches (2236±464) accounted for 16%, the dorsal cutaneous nerves of the hand (2565±382) accounted for 19%, the ulnar artery branches (418±210) accounted for 3%, the FCU distal branches (660±373) accounted for 5%, the FDP branches (930±441) accounted for 7%, the FCU proximal branches (914±223) accounted for 7%. Conclusions The fascicles of the intrinsic muscles of the hand are the most important fascicles of the ulnar nerve. The selective repair by using group fascicular suture techniques at the forearm and upper arm will reduce the required nerve fibers and will contribute to the functional recovery.
出处
《中华创伤骨科杂志》
CAS
CSCD
2004年第10期1132-1135,共4页
Chinese Journal of Orthopaedic Trauma
基金
广东省科技计划攻关项目(2002C31003)
关键词
尺神经
手内肌
功能分支
纤维定量
组织学
Ulnar nerve
Intrinsic muscles of hand
Functional branch
Quantitative analysis of fibers
Histology
