Mok David, Nikolis Andreas, Harris Patrick G
Division of Plastic and Reconstructive Surgery, Hôpital Notre-Dame, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada.
J Hand Surg Am. 2006 Apr;31(4):565-74. doi: 10.1016/j.jhsa.2005.12.021.
Detailed knowledge of the anatomy of the cutaneous innervation to the dorsal surface of the hand is valuable information. Because surgical access to the wrist often is obtained via the dorsal skin it would be helpful particularly to delineate an area where surgical incisions would not injure underlying nerves.
Thirty cadaver forearms were dissected carefully to examine in detail the anatomy of the lateral antebrachial cutaneous nerve, the superficial branch of the radial nerve, and the dorsal branch of the ulnar nerve. Each hand then was evaluated for an area free of any major nerve branches over the dorsal wrist.
Although the innervation to the dorsal hand varies certain patterns exist. The innervation pattern between the superficial branch of the radial nerve and the dorsal branch of the ulnar nerve is distributed evenly, dual innervation is frequent between the 2 nerves, and the lateral antebrachial cutaneous nerve is a common contributor to the innervation of the thumb. The superficial branch of the radial nerve and the dorsal branch of the ulnar nerve have identifiable branching patterns and have been classified according to a system developed for this study.
Two classification systems based on detailed dorsal hand cutaneous innervation patterns can be used to specify the placement of a safe dorsal skin incision away from major nerve branches.
对手背皮肤神经支配的详细解剖知识是有价值的信息。由于手腕的手术入路通常通过背部皮肤获得，特别有助于划定一个手术切口不会损伤其下方神经的区域。
仔细解剖30具尸体前臂，详细检查前臂外侧皮神经、桡神经浅支和尺神经手背支的解剖结构。然后评估每只手在腕背上方无任何主要神经分支的区域。
虽然手背的神经支配各不相同，但存在某些模式。桡神经浅支和尺神经手背支之间的神经支配模式分布均匀，这两条神经之间经常存在双重支配，前臂外侧皮神经是拇指神经支配的常见贡献者。桡神经浅支和尺神经手背支具有可识别的分支模式，并已根据本研究开发的系统进行分类。
基于手背皮肤详细神经支配模式的两种分类系统可用于确定远离主要神经分支的安全背部皮肤切口的位置。
