Develi Sedat
University of Health Sciences, Gulhane Faculty of Medicine, Department of Anatomy, Ankara, Turkey.
Turk Neurosurg. 2018;28(6):949-953. doi: 10.5137/1019-5149.JTN.22126-17.2.
To evaluate the existence of nerve innervation of the triceps brachii muscle via the ulnar nerve and its clinical importance in terms of nerve transfer or susceptibility to iatrogenic injuries during surgical procedures.
Thirty-five skeletally mature upper extremities of adult cadavers were included in the present study. The ulnar nerve was revealed from the medial cord to the distal part of the cubital fossa. The existence of the branches of the ulnar nerve and communicant branch of the radial nerve was examined in the brachium. The diameter and length of the variant nerve branches were measured.
A nerve branch from the ulnar nerve to the triceps brachii muscle was found in five of the dissected extremities (14.7%). The mean length and diameter of the variant nerve branch were 20.2 mm and 1.46 mm, respectively. The mean distance of the muscle entry point of the variant nerve branch from the bi-condylar line was 8.18 cm.
A variant nerve branch via the ulnar nerve can innervate the medial head of the triceps brachii at the distal third of the brachium. This variant nerve branch will be under risk of iatrogenic injury during elbow surgery and it seems to be an option for nerve grafts.
评估尺神经对肱三头肌的神经支配情况及其在神经移位或手术过程中易受医源性损伤方面的临床重要性。
本研究纳入了35具成年尸体的骨骼成熟上肢。显露尺神经从内侧束至肘窝远端部分。检查肱部尺神经分支及桡神经交通支的存在情况。测量变异神经分支的直径和长度。
在5个解剖上肢中发现了一条从尺神经至肱三头肌的神经分支(14.7%)。变异神经分支的平均长度和直径分别为20.2毫米和1.46毫米。变异神经分支肌肉进入点距双髁线的平均距离为8.18厘米。
通过尺神经的变异神经分支可在肱部远端三分之一处支配肱三头肌内侧头。该变异神经分支在肘部手术期间有医源性损伤风险,似乎是神经移植的一个选择。