骨间前神经旋前方肌支移位修复鱼际肌支、尺神经深支的解剖研究及临床应用  

ANATOMICAL STUDY AND CLINICAL APPLICATION OF TRANSFER OF PRONATOR QUADRATUS BRANCH OF ANTERIOR INTEROSSEOUS NERVE IN THE REPAIR OF THENAR BRANCH OF MEDIAN NERVE AND DEEP BRANCH OF ULNAR NERVE

作　　者：王岩[1] 朱盛修[1] 张伯勋[1] 

机构地区：[1]中国人民解放军总医院骨科

出　　处：《中国修复重建外科杂志》1997年第6期335-337,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：为了进一步证实骨间前神经移位术式的可行性，选用１０个新鲜前臂标本，对骨间前神经旋前方肌支、鱼际肌支及尺神经深支进行显微解剖，发现正中神经旋前方肌支直径为（１．５±０．４）ｍｍ，分别测量各肌支的有髓神经纤维数为（８６６±１４４）条；正中神经鱼际返支直径为（１．７±０．３）ｍｍ，有髓神经纤维数为（１１２０±９７）条；尺神经深支直径为（２．１±０．４）ｍｍ，有髓神经纤维数为（１３６８±１２０）条。用神经移植法可修复正中神经鱼际肌支，将尺神经深支向近端分离，可直接与旋前方肌支吻合。根据解剖特点，临床上应用正中神经旋前方肌支修复鱼际支１７例，修复尺神经深支３例。其中１７例随访２年～７年，１０例肌电图正常，肌力均有不同程度恢复，Ｍ２２例，Ｍ３５例，Ｍ４７例，Ｍ５３例。介绍了手术方法及注意事项。In order to obtain the anatomical basis of transferring the anterior interosseous nerve to repair the injury of thenar or ulnar nerve at the wrist level, ten fresh cadaveric forearms were dissected. The pronator quadratus branch of the median nerve was (1.5±0.4) mm in diameter with (866±144) nerve fibers. The recurrent branch of median nerve was (1.7±0.3) mm in diameter with (1 120±97) nerve fibers. The deep branch of ulnar nerve was (2.1± 0.4) mm in diameter with (1 318±120) nerve fibers. To repair the thenar recurrent branch, nerve graft should be used to bridge between the distal end of the anterior interosseous nerve and the origination of the recurrent branch. The deep branch of the ulnar nerve could be repaired by direct suture after being dissected proximally. In patients, the technique was applied to repair 17 cases of injury of thenar branch and 3 cases of injury of deep branch of ulnar nerve. Among them, seventeen cases were followed up from 2 to 7 years. On electromyogram it was normal in 10. The myodynamia was restored in different degree: M 2 in 2, M 3 in 5, M 4 in 7, M 5 in 3. The procedure of the operation and the matters needed attention during the operation were discussed.

关 键 词：周围神经 骨间前神经 鱼际肌支 解剖 修复 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学] R651.3[医药卫生—基础医学]