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[由于运动神经支配的变异对手部和前臂神经损伤的误判]

[Misinterpretation of nerve damage to the hand and forearm due to variations in the motor innervation].

作者信息

Botman Y A, Mulder J W

机构信息

Academisch Ziekenhuis Vrije Universiteit, afd. Plastische en Reconstructieve Chirurgie, Postbus 7057, 1007 MB Amsterdam.

出版信息

Ned Tijdschr Geneeskd. 2001 Jul 7;145(27):1316-20.

Abstract

A 21-year-old man served his ulnar nerve at the level of the left elbow. After nerve suturing only a slight loss of strength in two ulnar intrinsic hand muscles was found. Electromyographic examination revealed the crossing of some motor nerve fibres in the forearm from the median nerve to the ulnar nerve, innervating most of the first dorsal interosseous and the abductor digiti minimi muscle. One and a half years later there was still a loss of strength in the other ulnar muscles and a reduced sensitivity of the ulnar area, without a loss of function. Variations in the motor nerve supply of the hand, in particular connections between the median nerve and ulnar nerve in the forearm and hand are common. A complete transection of the ulnar nerve without complete paralysis of the ulnar intrinsic hand muscles can occur. If these variations are not considered, such a transection can be overlooked.

摘要

一名21岁男性的尺神经在左肘部水平处受到损伤。神经缝合后,仅发现手部两块尺侧固有肌轻度力量丧失。肌电图检查显示,前臂中一些运动神经纤维从正中神经交叉至尺神经,支配大部分第一背侧骨间肌和小指展肌。一年半后,其他尺侧肌肉仍存在力量丧失,尺侧区域感觉减退,但功能未丧失。手部运动神经供应的变异很常见,尤其是前臂和手部正中神经与尺神经之间的连接。尺神经完全横断而手部尺侧固有肌未完全瘫痪的情况可能发生。如果不考虑这些变异,这种横断可能会被忽视。

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