Zhao X, Hung L K, Zhang G M, Lao J
Department of Hand Surgery, Huashan Hospital, Shanghai Medical University, People's Republic of China.
Clin Orthop Relat Res. 2001 Sep(390):244-51. doi: 10.1097/00003086-200109000-00028.
Morphologic and internal topographic features of the axillary nerve were studied in 40 cadaveric shoulders to provide anatomic data for selective neurotization of the deltoid muscle in axillary nerve injury. The axillary nerve can be divided into three segments. Proximal to the subscapularis muscle, the axillary nerve is a single nerve trunk. Nerve fascicles to the deltoid muscle are identified at its lateral part. In front of the subscapularis muscle, the axillary nerve forms into the lateral and medial fasciculi groups. Distal to the subscapularis muscle, the nerve divides into anterior and posterior branches, which are continuations of the lateral and medial fasciculi groups, respectively. The anterior branch contains all fibers that innervate to the anterior and middle deltoid muscle. In 90% of cases, the posterior branch contains part or all nerve fibers to the posterior deltoid muscle. Nerve fibers to the teres minor and cutaneous sensory fibers are found in the posterior branch. In neurotization of the deltoid muscle, the best approach is to match the donor nerve to the lateral fasciculi group, which will give the highest percentage of reinnervation of the deltoid muscle.
对40具尸体肩部进行腋神经形态学和内部局部解剖特征研究，为腋神经损伤时三角肌选择性神经移植提供解剖学数据。腋神经可分为三段。在肩胛下肌近端，腋神经为单一神经干。在其外侧部分可识别出至三角肌的神经束。在肩胛下肌前方，腋神经形成外侧和内侧束组。在肩胛下肌远端，神经分为前支和后支，分别是外侧和内侧束组的延续。前支包含支配三角肌前部和中部的所有纤维。在90%的病例中，后支包含支配三角肌后部的部分或全部神经纤维。后支中发现有至小圆肌的神经纤维和皮感觉纤维。在三角肌神经移植中，最佳方法是将供体神经与外侧束组匹配，这将使三角肌再支配的比例最高。
