Tubbs R Shane, Tyler-Kabara Elizabeth C, Aikens Alan C, Martin Justin P, Weed Leslie L, Salter E George, Oakes W Jerry
Department of Cell Biology, University of Alabama at Birmingham, USA.
J Neurosurg. 2005 May;102(5):912-4. doi: 10.3171/jns.2005.102.5.0912.
There is a paucity of literature regarding the surgical anatomy of the quadrangular space (QS), which is a potential site of entrapment for the axillary nerve. Muscle hypertrophy of this geometrical area and fascial bands within it have been implicated in compression of the axillary nerve.
Fifteen human cadavers (30 sides) were dissected for this study. Measurements of the QS and its contents were made. The mean height of this space was 2.5 cm and the mean width 2.5 cm; its mean depth was 1.5 cm. The axillary nerve was always the most superior structure in the space, and in all cases the nerve and artery hugged the surgical neck of the humerus just superior to the origin of the lateral head of the triceps brachii muscle. This arrangement placed the axillary nerve in the upper lateral portion of the QS in all cadaveric specimens. The nerve branched into its muscular components within this space in 10 sides (33%) and posterior to it in 20 sides (66%). The cutaneous component of the axillary nerve branched from the main trunk of the nerve posterior to the QS in all specimens. Fascial bands were found in this space in 27 (90%) of 30 sides.
Knowledge of the anatomy of the QS may aid the surgeon who wishes to explore and decompress the axillary nerve within this geometrical confine.
关于四边形间隙（QS）的手术解剖学的文献较少，而四边形间隙是腋神经可能受压的部位。该几何区域的肌肉肥大及其内部的筋膜带与腋神经受压有关。
本研究解剖了15具人体尸体（30侧）。对四边形间隙及其内容物进行了测量。该间隙的平均高度为2.5厘米，平均宽度为2.5厘米；平均深度为1.5厘米。腋神经始终是该间隙中最靠上的结构，在所有病例中，神经和动脉均紧贴肱骨干的外科颈，恰好在肱三头肌外侧头起点的上方。这种排列方式使得在所有尸体标本中腋神经均位于四边形间隙的上外侧部分。在10侧（33%）中，神经在该间隙内分成其肌支，在20侧（66%）中在间隙后方分支。在所有标本中，腋神经的皮支均在四边形间隙后方从神经主干发出。在30侧中的27侧（90%）发现该间隙内有筋膜带。
了解四边形间隙的解剖结构可能有助于希望在这个几何范围内探查和松解腋神经的外科医生。
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