摘要
目的观察尺神经内手内肌功能束组在神经干的走行分布,为临床选择性修复提供依据。方法12具上肢标本,按照自然分束、醋酸浸滴法逆行显微解剖分离尺神经及其各功能束组,分段观察手内肌束组在神经干中的走行分布方位和与其它功能束的交错混合情况。测量神经干及手内肌神经束组的直径,计算其面积和手内肌束组的分布范围。结果尺神经干的形态和直径随平面位置的不同而变化。束组纤维在远端分化集中、定位明确,在近端混合弥散。手内肌神经束组是尺神经中最大的功能束组,在前臂和上臂3/8段以远,纤维相对集中(分布范围占神经的40%～60%),有明确的定位。结论在前臂和上臂3/8段以远,采用束组缝合法选择性修复手内肌功能束组,将减少神经纤维的散失,有助于其功能的恢复。
Objective To observe the arrangement and distribution of the fascicular groups in the ulnar nerve trunk to the intrinsic muscles so as to provide anatomical evidence for selective repair in the clinic.Methods 12 cadaveric upper extremities recently embalmed with formalin were obtained. The ulnar nerve and its branches were exposed. Microanatomy and longitudinal contradissection of each functional fascicular group were performed by tracing their terminal branches, and the arrangement and distribution were observed and recorded. The fascicular groups to the intrinsic muscles of hand in the nerve trunk were observed to see how they crossed and mixed with other fascicular groups. The diameter of the nerve trunk and the fascicles to the intrinsic muscles were measured, and the area and the distribution range of the fascicles calculated. Results The shape and the diameter of the ulnar nerve trunk varied at different positions. The fibers of functional fascicular groups had the definite differentiation at distal while interfused and diffused at proximal. The fascicular groups to the intrinsic muscles of hand were the largest and their fibers relatively concentrated (the distribution range occupied 40% ～ 80% of the ulnar nerve), and had the definite localization at the forearm and distal to the 3/8 segment of upper arm. Conclusion Since the fascicles to the intrinsic muscles of the hand are the most important in the ulnar nerve, selective repair by using epineural and perineural techniques at the forearm and upper arm will reduce the loss of nerve fibers and will contribute to the functional recovery.
出处
《中华创伤骨科杂志》
CAS
CSCD
2003年第3期218-221,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
功能束组
显微解剖学
神经纤维
Ulnar nerve
Intrinsic muscles of hand
Fascicular groups
Microanatomy
