Patra Apurba, Singh Manjit, Kaur Harsimarjit, Singla Rajan Kumar, Malhotra Vishal
Department of Anatomy, Government Medical College, Patiala, India.
Department of Orthopaedics, Maharishi Markandeshwer Institute of Medical Sciences and Research, Mullana, India.
Anat Cell Biol. 2018 Jun;51(2):93-97. doi: 10.5115/acb.2018.51.2.93. Epub 2018 Jun 27.
Several authors have made efforts to define the position of the axillary nerve within deltoid muscle and to calculate the so called safe area for this nerve but it still remains a matter of debate. The primary aim of the study was to investigate the acromio-axillary (AA) distance and its correlation with upper arm length. The secondary aim was to re-define the safe area for axillary nerve within deltoid muscle. Sixty shoulders of thirty adult human cadavers were dissected using standard methods. The distance from the anterior and posterior edge of acromion to the upper border of the course of the axillary nerve was measured and recorded as anterior and posterior AA distance respectively. Correlation analysis was done between the upper arm length and AA distance for each limb. The ratios between anterior and posterior AA distance and upper arm length were calculated and mentioned as anterior index and posterior index, respectively. The mean of anterior and posterior AA distance was 5.22 cm and 4.17 cm, respectively. The mean of upper arm length was 29.30 cm. The means of anterior index and posterior indices were 0.18 and 0.14, respectively. There was a significant correlation between upper arm length and both the anterior and posterior AA distance. The axillary nerve was found to lie at variable distance from the acromion. The minimum AA distance was found to be 3.50 cm. So this should be considered as the maximum permissible length of the deltoid split. Upper arm length has strong correlation with both anterior and posterior AA distances. The ideal safe area for the axillary nerve was found to be a quadrangular area above it and the size of which depends on the length of the upper arm.
几位作者已努力确定腋神经在三角肌内的位置，并计算该神经的所谓安全区，但这仍然是一个有争议的问题。本研究的主要目的是调查肩峰 - 腋窝（AA）距离及其与上臂长度的相关性。次要目的是重新定义三角肌内腋神经的安全区。使用标准方法解剖了30具成年人体尸体的60个肩部。测量并记录从肩峰前缘和后缘到腋神经走行上缘的距离，分别作为前AA距离和后AA距离。对每个肢体的上臂长度和AA距离进行相关性分析。计算前AA距离和后AA距离与上臂长度的比值，分别称为前指数和后指数。前AA距离和后AA距离的平均值分别为5.22 cm和4.17 cm。上臂长度的平均值为29.30 cm。前指数和后指数的平均值分别为0.18和0.14。上臂长度与前、后AA距离均存在显著相关性。发现腋神经与肩峰的距离各不相同。发现最小AA距离为3.50 cm。因此，这应被视为三角肌劈开的最大允许长度。上臂长度与前、后AA距离均有很强的相关性。发现腋神经的理想安全区是其上方的四边形区域，其大小取决于上臂的长度。
