Apaydin Nihal, Uz Aysun, Bozkurt Murat, Elhan Alaittin
Department of Anatomy, Ankara University School of Medicine, Ankara, Turkey.
Clin Anat. 2007 Apr;20(3):273-7. doi: 10.1002/ca.20361.
The axillary nerve has long been known to be one of the nerves vulnerable to damage during shoulder arthroscopic and open surgical procedures. The relationship of the axillary nerve to the shoulder capsule and the subscapularis muscle has not been well defined in orthopedic literature. This descriptive anatomical study aimed to present the course and the relations of the axillary nerve with neighboring neurovascular structures and the shoulder capsule and to define anatomical landmarks and regions that can be used practically in anterior surgical approaches to the shoulder region. To investigate the course of the axillary nerve and its relationship with neighboring structures, 30 shoulders of 15 fixed adult cadavers were dissected under the microscope through an anterior approach. A triangle-shaped anatomic area containing the axillary neurovascular bundle was defined. The closest distance between the axillary nerve and the anteromedial aspect of the coracoid tip and the glenoid labrum was measured as 3.7 cm and 1.1 cm on average, respectively. The distance between the anteromedial aspect of the coracoid tip and the point where the nerve passes through the medial edge of the subscapularis was measured as 2.5 cm on average. The results of this study demonstrate the anatomic pattern and the course of the axillary nerve and its relations with the shoulder capsule. Knowing the exact localization of the axillary nerve under the guidance of the defined anatomic triangle may provide a safer surgery.
长期以来，腋神经一直被认为是在肩关节镜手术和开放手术过程中易受损伤的神经之一。在骨科文献中，腋神经与肩袖和肩胛下肌的关系尚未得到明确界定。本描述性解剖学研究旨在展示腋神经的走行及其与邻近神经血管结构和肩袖的关系，并确定在肩部区域前路手术中可实际应用的解剖标志和区域。为了研究腋神经的走行及其与邻近结构的关系，通过前路在显微镜下解剖了15具固定成人尸体的30个肩部。定义了一个包含腋神经血管束的三角形解剖区域。腋神经与喙突尖和关节盂唇前内侧的最近距离平均分别为3.7厘米和1.1厘米。喙突尖前内侧与神经穿过肩胛下肌内侧缘处的距离平均为2.5厘米。本研究结果展示了腋神经的解剖模式、走行及其与肩袖的关系。在定义的解剖三角形的引导下了解腋神经的确切定位可能会使手术更安全。
