Poublon Alexander R, Kleinrensink Gert-Jan, Kerver Anton LA, Coert J Henk, Walbeehm Erik T
Department of Neuroscience and Anatomy, Erasmus MC, Rotterdam, Zuid-Holland 3000 CA, Netherlands.
Department of Plastic and Reconstructive surgery, Catharina Ziekenhuis, Eindhoven, Noord-Brabant 5623 EJ, Netherlands.
World J Orthop. 2018 Feb 18;9(2):7-13. doi: 10.5312/wjo.v9.i2.7.
To determine which of the common used incision techniques has the lowest chance of iatrogenic damage to the nerves which at risk are the superficial branch of the radial nerve (SBRN) and the Lateral Antebrachial Cutaneous Nerve (LABCN).
Twenty embalmed arms were dissected and the course of the SBRN and the LABCN in each individual arm was marked and the distance between the two branches of the SBRN at the location of the First Extensor Compartment (FEC) was measured. This data was used as input in a visualization tool called Computer Assisted Anatomy Mapping (CASAM) to map the course of the nerves in each individual arm.
This image visualizes that in 90% of the arms, one branch of the SBRN crosses the FEC and one branch runs volar to the compartment. The distance between the two branches was 7.8 mm at the beginning of the FEC and 10.2 mm at the end. Finally the angle of incision at which the chance of damage to the nerves is lowest, is 19.4 degrees volar to the radius.
CASAM shows the complexity of the course of the SBRN over the FEC. None of the four widely used incision techniques has a significantly lower chance of iatrogenic nerve damage. Surgical skills are paramount to prevent iatrogenic nerve damage.
确定常用的切开技术中，哪一种对有损伤风险的神经（即桡神经浅支（SBRN）和前臂外侧皮神经（LABCN））造成医源性损伤的几率最低。
解剖20具防腐处理的手臂，标记每只手臂中SBRN和LABCN的走行，并测量第一伸肌间隙（FEC）处SBRN两个分支之间的距离。该数据用作名为计算机辅助解剖绘图（CASAM）的可视化工具的输入，以绘制每只手臂中神经的走行。
该图像显示，在90%的手臂中，SBRN的一个分支穿过FEC，一个分支走行于该间隙的掌侧。在FEC起始处，两个分支之间的距离为7.8毫米；在末端为10.2毫米。最后，神经损伤几率最低的切开角度是相对于桡骨掌侧19.4度。
CASAM显示了SBRN在FEC上走行的复杂性。四种广泛使用的切开技术中，没有一种造成医源性神经损伤的几率显著更低。手术技巧对于预防医源性神经损伤至关重要。
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