Katcherian Christopher G, Strauch Robert J
Hand (N Y). 2010 Dec;5(4):382-5. doi: 10.1007/s11552-010-9262-z. Epub 2010 Mar 4.
The purpose of this study was to investigate the cutaneous nerves at risk during the posterior midline approach to the elbow and proximal ulna. Ten fresh frozen cadaver upper extremities were used for this study. A posterior midline skin incision extending from 10 cm proximal to 15 cm distal to the olecranon tip was created. All superficial nerves were identified and preserved. Nerve diameters were measured, their distance from the olecranon tip assessed, and they were dissected proximally to confirm their nerve of origin. Point of nerve arborization to skin from the midline incision was quantified. An average of one confirmed nerve proximal and five distal to the olecranon tip were identified with an average diameter of 0.9 mm proximal and 1.3 mm distal to the olecranon. The largest nerves were typically located 2 cm proximal (range 7-46 mm) and 45 mm distal (range 9-135 mm) to the olecranon. The branches arborized into the skin an average of 5.2 mm lateral to the incision. All nerves joined the posterior medial antebrachial cutaneous nerve. The branches of the medial antebrachial cutaneous nerve are at risk with a straight posterior midline elbow incision, though the clinical significance of injury to these nerves at this location is unknown.
本研究的目的是调查经肘部和尺骨近端后正中入路时存在风险的皮神经。本研究使用了10个新鲜冷冻的尸体上肢。在鹰嘴尖近端10 cm至远端15 cm处做一个后正中皮肤切口。识别并保留所有浅表神经。测量神经直径，评估其与鹰嘴尖的距离，并向近端解剖以确认其起源神经。对从中线切口至皮肤的神经分支点进行量化。在鹰嘴尖近端平均识别出1条已确认的神经，在远端平均识别出5条，鹰嘴尖近端神经平均直径为0.9 mm，远端为1.3 mm。最大的神经通常位于鹰嘴近端2 cm（范围7 - 46 mm）和远端45 mm（范围9 - 135 mm）处。分支在切口外侧平均5.2 mm处进入皮肤。所有神经均汇入前臂后内侧皮神经。采用肘部后正中直切口时，前臂内侧皮神经的分支有风险，不过在此位置损伤这些神经的临床意义尚不清楚。
