桡骨交锁钉固定防止桡神经深支损伤的应用解剖  

The protection of the deep branch of radial nerve during the fixation process of radial interlocking intramedully nails: Clinical anatomy

作　　者：言湛军[1] 郑祖根 董启榕[1] 赵洪[1] 

机构地区：[1]苏州大学附属第二医院骨科,江苏苏州215004

出　　处：《中国临床解剖学杂志》2007年第4期364-366,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:为桡骨交锁髓内钉固定术避免桡神经深支损伤提供解剖学依据。方法:前臂标本44侧解剖显露桡神经深支,将肱骨外上髁与Lister结节连线和桡骨头关节面,关节面下1.0、1.5、2.0cm,桡神经深支穿入旋后肌平面,桡神经深支跨越桡骨平面等6个面的交点,依次标记为A、B、C、D、E、F6个点。记录AE、AF的长度,测量B、C、D3个定点在屈肘前臂旋前、中立、旋后位与桡神经深支的水平距离。结果:B、C、D3个定点离桡神经深支的距离越来越近;而对于同一定点,其与桡神经深支的距离按旋前、中立、旋后位的顺序越来越远。结论:桡骨交锁髓内钉固定时,宜于屈肘前臂中立位,在肱骨外上髁与Lister结节连线上,距桡骨头关节面约1.5cm的位置,由前臂后外侧向前内侧插入远端交锁螺丝钉较为安全。Objective： To provide anatomical basis for the use of radial interlocking intramedully nails and the protection of deep branch of radial nerve. Methods： The deep branches of radial nerve were dissected on 44 fresh forearm specimens. The line between lateral epicondyle of humerus and Lister tubercle of radius, the line passed through 6 horizontal planes, which were taken as follows in sequence： 0, 1.0cm, 1.5cm, 2.0cm lower than the articular facet of radial head respectively, the horizontal plane of the deep branch of radial nerve entering the supinator and winding across the radius formed intersections, and the crossed points were named as point A, B, C, D, E, F accordingly. The distance between the deep branch of radial nerve and the fixed points B, C, D was measured separately when the forearm was kept in pronation, neutral and supination position. Results： The distance between the deep branch of radial nerve and the points B, C, D gradually decreased, while at the position ofpronation, neutral and supination, the distance increased gradually. Conclusions： During the fixation process, it is relatively safe to keep the forearm in neutral position, and insert the distal locking nail at point B from the posterolateral to anteromedial direction.

关 键 词：桡神经深支 桡骨 交锁钉 应用解剖 

分 类 号：R322.71[医药卫生—人体解剖和组织胚胎学] R681.7[医药卫生—基础医学]