腕关节背侧入路与浅表神经的解剖关系：尸体研究。

Anatomic relation of dorsal wrist arthroscopy portals and superficial nerves: a cadaveric study.

机构信息

Department of Anatomy, Sheffield Medical School, Sheffield, England.

出版信息

Arthroscopy. 2009 Dec;25(12):1387-90. doi: 10.1016/j.arthro.2009.06.005. Epub 2009 Nov 7.

DOI:10.1016/j.arthro.2009.06.005

PMID:19962064

Abstract

PURPOSE

The aim of this cadaveric study was to assess and compare the distance of commonly used dorsal wrist portals to the dorsal ulnar and radial superficial nerves and their branches.

METHODS

Twenty embalmed cadaveric upper limbs were dissected, exposing the nerves and tendons, and wrist arthroscopy portal sites were marked with pins. The horizontal distance between the portals and closest nerve branch was measured with a digital caliper. Statistical analysis of the data was performed with SPSS software for Windows (version 11.5; SPSS, Chicago, IL) by use of Friedman tests and Wilcoxon signed rank tests.

RESULTS

The median distance of the nearest nerve branch to portal 1-2 was 1.82 mm; portal 3-4, 4.85 mm; portal 4-5, 16.13 mm; portal 6U, 2.47 mm; and midcarpal radial portal (MCP), 6.65 mm. The 4-5 portal was safer than the 1-2 portal (P < .0001), 3-4 portal (P = .015), MCP (P = .001), and 6U portal (P < .0001). The MCP was safer than the 1-2 portal (P = .01), 3-4 portal (P = .019), and 6U portal (P = .003).

CONCLUSIONS

The 4-5 portal is further away from a nerve branch than any other portal, followed by the MCP.

CLINICAL RELEVANCE

The results of this study may be of use in the planning of wrist arthroscopy.

摘要

目的

本尸体研究旨在评估和比较常用的背侧腕关节入路与背侧尺侧和桡侧浅神经及其分支的距离。

方法

对 20 具防腐上肢尸体进行解剖，暴露神经和肌腱，并使用大头针标记腕关节关节镜入路点。使用数字卡尺测量入路点与最近神经分支之间的水平距离。使用 Windows 版 SPSS 软件（版本 11.5；SPSS，芝加哥，IL）对数据进行统计分析，采用 Friedman 检验和 Wilcoxon 符号秩检验。

结果

最近神经分支到 1-2 入路的中位数距离为 1.82mm；3-4 入路为 4.85mm；4-5 入路为 16.13mm；6U 入路为 2.47mm；中腕桡侧入路（MCP）为 6.65mm。4-5 入路比 1-2 入路（P<0.0001）、3-4 入路（P=0.015）、MCP（P=0.001）和 6U 入路（P<0.0001）更安全。MCP 比 1-2 入路（P=0.01）、3-4 入路（P=0.019）和 6U 入路（P=0.003）更安全。