Choo Joshua, Wilhelmi Bradon J, Kasdan Morton L
University of Louisville, KY, USA.
Veterans Affairs Hospital, Louisville, KY, USA.
Hand (N Y). 2017 Jan;12(1):NP6-NP9. doi: 10.1177/1558944716648313. Epub 2016 May 9.
A rare and disastrous complication of harvesting a tendon graft is the misidentification of the median nerve for the palmaris longus. The authors report a referred case in which the median nerve was harvested as a free tendon graft. Few reports of this complication are found in the literature despite the frequency of palmaris longus tendon grafting and the proximity of the palmaris tendon to the median nerve. Given the obvious medicolegal implications, the true incidence of this complication is difficult to assess. Safe harvesting of the palmaris longus mandates a thorough understanding of the relevant anatomy, in particular the proper differentiation between nerve and tendon and recognition of when the palmaris longus tendon is absent. Techniques to facilitate proper identification of the palmaris longus are outlined.
获取肌腱移植物时一种罕见且灾难性的并发症是将正中神经误认作掌长肌。作者报告了一例转诊病例，其中正中神经被当作游离肌腱移植物获取。尽管掌长肌腱移植很常见且掌长肌腱与正中神经位置接近，但文献中关于这种并发症的报道很少。鉴于明显的法医学意义，这种并发症的真实发生率难以评估。安全获取掌长肌需要对相关解剖结构有透彻的了解，尤其是要正确区分神经和肌腱，并识别掌长肌腱何时缺如。文中概述了有助于正确识别掌长肌的技术。
