Voigt Clifford, Illical Emmanuel, Goyal Kanu S, Farrell Dana J, Van Eck Carola F, Tarkin Ivan S
Department of Orthopaedic Surgery, Division of Orthopaedie Traumatology, University of Pittsburgh Medical Center, Pittsburgh, PA.
J Orthop Trauma. 2015 Feb;29(2):e43-5. doi: 10.1097/BOT.0000000000000204.
To determine whether the type of posterior surgical approach for distal humeral fracture open reduction and internal fixation influenced radial nerve strain during simulated operative retraction in a cadaveric model.
Three different posterior surgical exposures: triceps splitting, lateral paratricipital, and paratricipital with release of the lateral intermuscular septum were used. Radial nerve strain was measured using a microDVRT, while traction was applied with a digital force gauge at forces 0.1-0.3 kg.
The lateral paratricipital with nerve decompression was superior to both the triceps splitting approach (P < 0.048) and paratricipital method without decompression (P < 0.036). There was no significant difference between the triceps splitting method and paratricipital exposure without intermuscular septum release.
Radial nerve decompression through release of the lateral intermuscular septum through a lateral paratricipital exposure ideally decreases nerve strain during humeral open reduction and internal fixation in our cadaveric model.
在尸体模型中确定肱骨远端骨折切开复位内固定术的后路手术方式是否会在模拟手术牵开过程中影响桡神经应变。
采用三种不同的后路手术显露方式：三头肌劈开、外侧三头肌旁入路以及外侧肌间隔松解的三头肌旁入路。使用微型数字视频应变计测量桡神经应变，同时用数字测力计以0.1 - 0.3千克的力施加牵引。
外侧三头肌旁入路并进行神经减压优于三头肌劈开入路（P < 0.048）和未减压的三头肌旁入路（P < 0.036）。三头肌劈开法与未松解肌间隔的三头肌旁入路之间无显著差异。
在我们的尸体模型中，通过外侧三头肌旁入路松解外侧肌间隔进行桡神经减压，理想情况下可在肱骨切开复位内固定术中降低神经应变。
