Ashfaq Hasan S, Rauls Russell B, Cordell Cari L, Bailey Mark S, Nguyen Thao
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland.
J Surg Orthop Adv. 2014 Summer;23(2):105-10. doi: 10.3113/jsoa.2014.0105.
The authors of this study sought improved understanding of the radial nerve course through the brachium and hypothesized that the most proximal aspect of the triceps tendon (PATT) serves as a useful superficial landmark for localizing the nerve. It was also hypothesized that a poorly appreciated area of vulnerability for nerve injury exists where the radial nerve runs along the lateral cortex of the humerus proximal to its transit through the lateral intermuscular septum (LIMS). The authors assessed 33 fresh-frozen cadaveric specimens. A 6.7-cm span of the nerve lies directly on the periosteum of the humerus before piercing the LIMS. The proximal 4.6cm abuts the posterior cortex. The final 2.1cm just proximal to the LIMS runs along the lateral cortex. The nerve at the posterior midline of the humerus is 2.3cm proximal to the level of the PATT. The radial nerve lies directly on the lateral humeral cortex for 2cm proximal to its transit through the LIMS. The PATT appears to be a consistent and practical superficial landmark to determine the location of the radial nerve from a posterior approach.
本研究的作者试图更好地了解桡神经在臂部的走行，并假设肱三头肌腱最近端部分（PATT）可作为定位该神经的有用体表标志。他们还假设，在桡神经穿过外侧肌间隔（LIMS）之前沿肱骨外侧皮质走行的区域，存在一个未被充分认识的神经损伤易患区。作者评估了33个新鲜冷冻尸体标本。在穿过LIMS之前，6.7厘米长的神经段直接位于肱骨骨膜上。近端4.6厘米与后皮质相邻。在LIMS近端最后的2.1厘米沿外侧皮质走行。肱骨后中线处的神经比PATT水平近端2.3厘米。桡神经在穿过LIMS之前，在其近端2厘米处直接位于肱骨外侧皮质上。PATT似乎是一个一致且实用的体表标志，可从后方入路确定桡神经的位置。
