Benedikt S, Parvizi D, Feigl G, Koch H
Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/4, 8036 Graz, Austria.
Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/4, 8036 Graz, Austria.
J Plast Reconstr Aesthet Surg. 2017 Nov;70(11):1582-1588. doi: 10.1016/j.bjps.2017.06.025. Epub 2017 Jun 28.
During cubital tunnel surgery, the medial antebrachial cutaneous nerve (MACN) may be injured, causing painful scars, neuromas, hypaesthesia or hyperalgesia. As the literature on the anatomy of crossing branches in this area is contradictory, this study aimed to re-examine the anatomy of the MACN in this region.
Forty upper limbs were dissected. We looked specifically from 5 cm proximal to 6 cm distal to the medial epicondyle (ME) and documented the number of crossing branches and the distances between the crossing points and the ME; we also measured the length of each limb.
The most common location for crossing branches was 2 cm distal to the ME. Twenty-seven branches (∼23%) were found proximal to or at the level of the ME, and 91 branches (∼77%) were distal to it. The average distance between the proximal crossing points and the ME was 1.7 cm, the mean number of crossing branches was 0.7 and at least one crossing branch per limb was found in 16/40 cases. For the distal crossing points, the average distance to the ME was 2.9 cm, the mean number of crossing branches was 2.3 and at least one crossing branch per limb was found in all cases. There was no correlation between the limb lengths and the number of crossing branches.
Because the incidence of posterior branches of the MACN crossing the course of the ulnar nerve is 100%, it is important to take the anatomy of the MACN into consideration when undertaking ulnar nerve surgery.
在尺神经沟手术过程中，前臂内侧皮神经（MACN）可能会受到损伤，导致疼痛性瘢痕、神经瘤、感觉减退或痛觉过敏。由于关于该区域交叉分支解剖结构的文献存在矛盾之处，本研究旨在重新审视该区域MACN的解剖结构。
解剖了40条上肢。我们特别观察了从内上髁（ME）近端5厘米至远端6厘米的区域，并记录交叉分支的数量以及交叉点与ME之间的距离；我们还测量了每条肢体的长度。
交叉分支最常见的位置是在ME远端2厘米处。在ME近端或其水平发现27条分支（约23%），在其远端发现91条分支（约77%）。近端交叉点与ME之间的平均距离为1.7厘米，交叉分支的平均数量为0.7条，40例中有16例每条肢体至少有一条交叉分支。对于远端交叉点，与ME的平均距离为2.9厘米，交叉分支的平均数量为2.3条，所有病例中每条肢体至少有一条交叉分支。肢体长度与交叉分支数量之间无相关性。
由于MACN后支越过尺神经走行的发生率为100%，因此在进行尺神经手术时考虑MACN的解剖结构非常重要。
