Sukegawa K, Kuniyoshi K, Suzuki T, Ogawa Y, Okamoto S, Shibayama M, Kobayashi T, Takahashi K
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Bone Joint J. 2014 Jun;96-B(6):789-94. doi: 10.1302/0301-620X.96B6.33656.
We conducted an anatomical study to determine the best technique for transfer of the anterior interosseous nerve (AIN) for the treatment of proximal ulnar nerve injuries. The AIN, ulnar nerve, and associated branches were dissected in 24 cadaver arms. The number of branches of the AIN and length available for transfer were measured. The nerve was divided just proximal to its termination in pronator quadratus and transferred to the ulnar nerve through the shortest available route. Separation of the deep and superficial branches of the ulnar nerve by blunt dissection alone, was also assessed. The mean number of AIN branches was 4.8 (3 to 8) and the mean length of the nerve available for transfer was 72 mm (41 to 106). The transferred nerve reached the ulnar nerve most distally when placed dorsal to flexor digitorum profundus (FDP). We therefore conclude that the AIN should be passed dorsal to FDP, and that the deep and superficial branches of the ulnar nerve require approximately 30 mm of blunt dissection and 20 mm of sharp dissection from the point of bifurcation to the site of the anastomosis. The use of this technique for transfer of the AIN should improve the outcome for patients with proximal ulnar nerve injuries.
我们进行了一项解剖学研究，以确定用于治疗尺神经近端损伤的骨间前神经（AIN）移位的最佳技术。在24具尸体手臂中解剖了AIN、尺神经及相关分支。测量了AIN的分支数量和可用于移位的长度。在旋前方肌中，将神经在其终末近端切断，并通过最短路径移位至尺神经。还评估了仅通过钝性分离来分开尺神经深浅分支的情况。AIN分支的平均数量为4.8（3至8个），可用于移位的神经平均长度为72 mm（41至106 mm）。当置于指深屈肌（FDP）背侧时，移位的神经最远端可到达尺神经。因此，我们得出结论，AIN应从FDP背侧穿过，并且从尺神经分叉点到吻合部位，其深浅分支需要约30 mm的钝性分离和20 mm的锐性分离。使用该技术进行AIN移位应能改善尺神经近端损伤患者的治疗效果。
