Lowe James B, Maggi Sergio P, Mackinnon Susan E
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
Plast Reconstr Surg. 2004 Sep 1;114(3):692-6. doi: 10.1097/01.prs.0000130966.16460.3c.
The posterior branch of the medial antebrachial cutaneous nerve courses in proximity to the cubital tunnel and is particularly prone to injury during ulnar nerve release at the elbow. Inadvertent injury to medial antebrachial cutaneous nerve branches during surgery can result in the formation of painful neuromas that can be misdiagnosed as recurrent disease. It is important to understand the relevant anatomy of the medial antebrachial cutaneous nerve branches during cubital tunnel surgery to avoid significant postoperative morbidity. This prospective observational anatomic study examined the position of the posterior branch of the medial antebrachial cutaneous nerve in relationship to a standard approach to the cubital tunnel in a randomly selected group of 97 patients undergoing primary surgery over a 3-year period. Medial antebrachial cutaneous nerve branches were noted to cross at or proximal to the medial humeral epicondyle 61 percent of the time at an average proximal distance of 1.8 cm. Medial antebrachial cutaneous nerve branches were noted to cross distal to the medial humeral epicondyle 100 percent of the time at an average distal distance of 3.1 cm. Understanding the general position of crossing medial antebrachial cutaneous nerve branches during ulnar nerve release at the elbow may help to prevent iatrogenic injury to this cutaneous nerve.
前臂内侧皮神经后支在尺神经沟附近走行，在肘部尺神经松解手术中特别容易受到损伤。手术过程中意外损伤前臂内侧皮神经分支可导致疼痛性神经瘤形成，可能被误诊为复发性疾病。在尺神经沟手术中了解前臂内侧皮神经分支的相关解剖结构对于避免显著的术后并发症很重要。这项前瞻性观察性解剖学研究在一组随机选择的97例接受初次手术的患者中，研究了前臂内侧皮神经后支相对于尺神经沟标准入路的位置，该研究为期3年。发现前臂内侧皮神经分支在肱骨内上髁内侧或其近端交叉的情况占61%，平均近端距离为1.8厘米。发现前臂内侧皮神经分支在肱骨内上髁内侧远端交叉的情况占100%，平均远端距离为3.1厘米。了解在肘部尺神经松解时前臂内侧皮神经分支交叉的大致位置可能有助于预防对该皮神经的医源性损伤。
