摘要
目的：为尺神经深支卡压和损伤的临床诊治以及高位尺神经损伤直接移植修复尺神经深支提供解剖学依据。方法：选择30侧自肘以上离断新鲜完整无畸形上肢进行解剖，观察尺神经深支的走行和分支。测量小鱼际各肌支的长度、宽度和厚度；尺神经深支相邻肌支间距离；豌豆骨近缘至深支最末分支间长度；尺神经深支逆向可分离长度和分离后的近端宽度和厚度，骨问前神经旋前方肌支远端宽度和厚度。结果：尺神经深支分支复杂，呈树枝状结构，在其走行过程中经Guyon管、豆钩管、对掌肌管、拇收肌腱弓等，解剖关系复杂。相应骨问肌支和蚓状肌支大部在尺神经深支主干同一平面呈不同角度发出。结论：尺神经深支易卡压部位多，可能是高位尺神经损伤后手内在肌功能不易恢复的原因之一；邻近骨折脱位较易损伤尺神经深支；高位尺神经损伤早期行神经移位直接修复尺神经深支，有利于手功能的恢复。
Objective： To provide anatomical basis of neural transplantation to repair deep branch of the ulnar nerve early after injury to the superior position on profundus nervi ulnaris, clinical diagnosis and treatment of injury, and compression of ulnar nerve. Methods： Thirty fresh upper limbs mutilated above elbow without abnormality were dissected. The course and branches of the deep branch of the ulnar nerve were observed. The construction of the wrist ulnar canal, the muscles innerved from the deep branch of the ulnar nerve were investigated. The length, width, thickness and the points to enter muscles of branches of the deep branch of the ulnar nerve in muscle of hypothenar and the length of the consecutive branches from the branch of abductor digiti minimi to the branch of the second palmar interossei were measured. The length of the deep branch of the ulnar nerve from proximate of pisiform bone to ending branch and the segregated deep branch of the ulnar nerve, the diameter of the proximate of the segregated deep branch of the ulnar nerve and the distal end of the pronator quadratus branch of anterior interosseous nerve were measured emphatically. Data analyses were performed with a statistical analysis package （x±s）. Results： The deep branch of the ulnar nerve was arborization pattern and complicated, and it went through Guyon＇s canal, pisohamate tunnel, opponens canal and musculotendinous arch of adductor muscle of thumb. Conclusion： There were many compressional factors of the deep branch of the ulnar nerve which may not lead intrinsic muscles of hand to good function. Adjacent fracture and dislocation may result in injury of the deep branch of the ulnar nerve easily. The deep branch of the ulnar nerve repaired directly after injury of inferior trunk or medial cord of braehial plexus may benefit functional restoration of the hand.
出处
《解剖学杂志》
CAS
CSCD
北大核心
2009年第5期666-668,共3页
Chinese Journal of Anatomy
关键词
尺神经深支
解剖学
腕尺管
臂丛神经损伤
骨间前神经
profundus nervi ulnaris
anatomy
wrist ulnar canal
brachial plexus injury
anterior interosseous nerve
