Rotari Vladimir, Moussallem Charbel D, David Emmanuel, Mertl Patrice, Havet Eric
Resident, Department of Orthopedic Surgery, Amiens University Medical Center, Jules Verne University, Picardie, France.
Am J Orthop (Belle Mead NJ). 2012 Oct;41(10):452-5.
Many studies have attempted to define a safety zone for the axillary nerve in lateral approaches to the deltoid, but with varying results. The main objective of our study was to analyze the variations in the position of this nerve, especially in relation to the length of the humerus. Overall, 16 cadaveric shoulders were dissected. The distances between both the anterolateral edge of the acromin (anterior distance) and the lateral edge of the acromion (posterior distance) to the axillary nerve were measured; the length of the humerus was also measured. Correlation analysis was performed between each distance and the length of the humerus. The average anterior and posterior distance were 7.2 cm ± 0.84 cm and 7.9 cm ± 0.92 cm, respectively; the average length of the humerus was 30.7 cm ± 3.2 cm. A significantly high positive correlation was found between the length of the humerus and both anterior distance (P = .94), and posterior distance (P = .92). In shoulder surgery, prior measurement of the length of the humerus could predict the distance between the acromion and the axillary nerve, and determine its position.
许多研究试图确定在三角肌外侧入路中腋神经的安全区,但结果各异。我们研究的主要目的是分析该神经位置的变异情况,尤其是与肱骨长度的关系。总体而言,解剖了16具尸体肩部标本。测量了肩峰前外侧缘至腋神经的距离(前方距离)以及肩峰外侧缘至腋神经的距离(后方距离);同时也测量了肱骨的长度。对每个距离与肱骨长度进行了相关性分析。前方距离和后方距离的平均值分别为7.2 cm±0.84 cm和7.9 cm±0.92 cm;肱骨的平均长度为30.7 cm±3.2 cm。发现肱骨长度与前方距离(P = 0.94)和后方距离(P = 0.92)之间均存在显著的高度正相关。在肩部手术中,术前测量肱骨长度可预测肩峰与腋神经之间的距离,并确定其位置。