Yamaguchi K, Sweet F A, Bindra R, Gelberman R H
Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO 63110, USA.
J Shoulder Elbow Surg. 1999 Jan-Feb;8(1):17-21. doi: 10.1016/s1058-2746(99)90048-4.
The purpose of this report was to investigate the vascular anatomy of the ulnar nerve at the elbow with a technique of combined India ink and latex injection followed by nondissection chemical debridement. Twenty-two fresh human cadaveric arms were injected with India ink to stain the intraneural microcirculation followed immediately by latex injection and chemical debridement for study of the extraneural vascularization. After clearing with a modified Spalteholtz technique, the intraneural blood supply was studied in 10 of the specimens. The findings demonstrated a consistent but segmental extraneural and intraneural vascular supply from the superior ulnar collateral, inferior ulnar collateral, and posterior ulnar recurrent arteries. No identifiable direct anastomosis was seen between the superior ulnar collateral and posterior ulnar recurrent arteries in 20 of 22 arms. The inferior ulnar collateral artery provided the only direct vascularization to the nerve in the region just proximal to the cubital tunnel. Although the clinical importance of maintaining specific arterial sources to the ulnar nerve has not been determined, these anatomic findings indicate that the arterial contribution from the inferior ulnar collateral artery may be more important than appreciated previously.
本报告的目的是采用印度墨水和乳胶联合注射技术，随后进行非解剖性化学清创，研究肘部尺神经的血管解剖结构。对22条新鲜人尸体手臂注射印度墨水以染色神经内微循环，随后立即进行乳胶注射和化学清创，以研究神经外血管化。采用改良的斯帕尔托兹技术清除组织后，对其中10个标本进行神经内血供研究。研究结果表明，尺侧上副动脉、尺侧下副动脉和尺侧后返动脉提供了一致但呈节段性的神经外和神经内血管供应。在22条手臂中的20条中，未发现尺侧上副动脉与尺侧后返动脉之间有可识别的直接吻合。尺侧下副动脉是肘管近端区域神经的唯一直接血管供应。虽然维持尺神经特定动脉来源的临床重要性尚未确定，但这些解剖学发现表明，尺侧下副动脉的动脉供血可能比之前认为的更为重要。
