Tatar Ilkan, Kocabiyik Necdet, Gayretli Ozcan, Ozan Hasan
Department of Anatomy, Hacettepe University Medical School, Sihhiye, 06100, Ankara, Turkey.
Surg Radiol Anat. 2009 Oct;31(8):591-6. doi: 10.1007/s00276-009-0487-x. Epub 2009 Mar 10.
We aimed to make first demonstration of the course and branching pattern of deep branch of the radial nerve (DBRN) in relation to the supinator muscle in the forearms of fetuses and make morphological measurements in both fetuses and adults. We carried out dissection on 80 radial nerves from 20 adult cadavers (16 males and 4 females), ranging from 30 to 56 years old and 20 formalin-fixed, spontaneously aborted fetuses (10 males and 10 females) without detectable malformations, ranging from 20 to 37 weeks of gestation. There were three different branching patterns of the DBRN in fetuses. It divided its terminal branches at entrance of the supinator in 2 (5%), after entry of the supinator in 4 (10%) and after the supinator in 34 (85%) forearms. The course was bilaterally same in fetuses. Dividing pattern at the entrance of the supinator was not seen in adults. Only 4 (10%) were seen at after entering to the supinator and 36 (90%) were seen at after the supinator. We saw in fetuses neither fibrous band deep from the extensor carpi radialis longus nor upper border of the supinator. We assume that these fibrous structures appear after birth, perhaps favored by physical exercise, such as repeated pronation-supination movements. We think that it is one of the reasons why DBRN compression has never been reported in children. This is the first fetal study about the course and branching pattern of the DBRN and there is a constant ratio (mean 4.3) between the measurements of the fetuses and adults.
我们旨在首次展示胎儿前臂桡神经深支（DBRN）相对于旋后肌的走行及分支模式，并对胎儿和成人进行形态学测量。我们对20具成人尸体（16例男性和4例女性）的80条桡神经进行了解剖，年龄在30至56岁之间，以及20例福尔马林固定的、自然流产的无明显畸形胎儿（10例男性和10例女性）的桡神经进行了解剖，孕周在20至37周之间。胎儿的DBRN有三种不同的分支模式。在2例（5%）前臂中，它在旋后肌入口处就分出终末支；在4例（10%）中，在旋后肌进入后分出；在34例（85%）中，在穿过旋后肌后分出。胎儿两侧的走行相同。在成人中未见到在旋后肌入口处分支的模式。仅4例（10%）在进入旋后肌后见到这种情况，36例（90%）在穿过旋后肌后见到。在胎儿中，我们未见到桡侧腕长伸肌深部的纤维带和旋后肌上缘。我们推测这些纤维结构在出生后出现，可能受体育锻炼的影响，如反复的旋前 - 旋后运动。我们认为这是儿童中从未报道过DBRN受压的原因之一。这是关于DBRN走行及分支模式的首次胎儿研究，胎儿和成人的测量值之间存在恒定比例（平均4.3）。
