桡骨近端标准入路中骨间后神经损伤的风险:一项尸体研究。

The risk injury to the posterior interosseous nerve in standard approaches to the proximal radius: a cadaver study.

作者信息

Heidari Nima, Kraus Tanja, Weinberg Annelie M, Weiglein Andreas H, Grechenig Wolfgang

机构信息

Department of Trauma and Orthopaedics, Royal London Hospital, Whitechapel, London, UK.

出版信息

Surg Radiol Anat. 2011 May;33(4):353-7. doi: 10.1007/s00276-010-0718-1. Epub 2010 Aug 28.

Abstract

PURPOSE

The aim of this study was to provide guidance on the safe zones for the exposure of the proximal radius by measuring the distance from the PIN to various anatomical landmarks in the proximal forearm in pronation and supination.

METHODS

Twenty cadaveric arms were used for this study. On the anterior aspect of the forearm, the distance between insertion of the biceps tendon and the arcade of Frohse as well as the shortest distance between the PIN and the ulnar aspect of the radial neck were measured. On the posterior aspect of the forearm, the shortest distance between the PIN and the ulnar border of the interosseous membrane was measured at 30 and 50 mm distal to the articular surface of the radial head.

RESULTS

The distance between the PIN and ulnar aspect of the radial neck had a mean of 21.6 mm in supination and 13.3 mm in pronation. The distance between the radial tuberosity and the arcade of Frohse was 18.6 mm. The mean distance between the PIN and the radial border of ulna at 30 mm distal to the articular surface of the proximal radius was 12.3 mm in supination and 22.3 mm in pronation. At 50 mm distal to the articular surface of the proximal radius the mean distance was 8 mm in supination and 16.2 mm in pronation.

CONCLUSIONS

The course of this nerve is variable as it winds around the radial neck within the belly of the supinator muscle. Safe distances for dissection have been presented in our study.

摘要

目的

本研究旨在通过测量旋前和旋后时桡骨近端骨间背神经(PIN)到前臂近端各解剖标志的距离,为桡骨近端暴露的安全区域提供指导。

方法

本研究使用了20具尸体手臂。在前臂前面,测量肱二头肌腱止点与弗罗瑟弓之间的距离以及PIN与桡骨颈尺侧的最短距离。在前臂后面,在桡骨头关节面远侧30和50毫米处测量PIN与骨间膜尺侧缘之间的最短距离。

结果

PIN与桡骨颈尺侧的距离在旋后时平均为21.6毫米,在旋前时为13.3毫米。桡骨粗隆与弗罗瑟弓之间的距离为18.6毫米。在桡骨近端关节面远侧30毫米处,PIN与尺骨桡侧缘之间的平均距离在旋后时为12.3毫米,在旋前时为22.3毫米。在桡骨近端关节面远侧50毫米处,平均距离在旋后时为8毫米,在旋前时为16.2毫米。

结论

该神经在旋后肌肌腹内绕桡骨颈走行,其行程多变。本研究给出了解剖的安全距离。

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