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肱三头肌神经支配模式的手术意义:一项尸体研究

Surgical Implications of Innervation Pattern of the Triceps Muscle: A Cadaveric Study.

作者信息

Chaware Prashant Nashiket, Santoshi John Ashutosh, Patel Manmohan, Ahmad Mohtashim, Rathinam Bertha A D

机构信息

Department of Anatomy, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

出版信息

J Hand Microsurg. 2018 Dec;10(3):139-142. doi: 10.1055/s-0038-1660771. Epub 2018 Jun 20.

Abstract

The innervation pattern of triceps is complex and not fully comprehended. Anomalous innervations of triceps have been described by various authors. We have attempted to delineate the nerve supply of the triceps and documented the anomalous innervations of its different heads. The brachial plexus and its major branches (in the region of the axilla and arm) and triceps were dissected in 36 embalmed cadaver upper limbs. Long head received one branch from radial nerve in 31 (86%) specimens. Four (11%) specimens received two branches including one that had dual innervation from the radial and axillary nerves, and one (3%) specimen had exclusive innervation from a branch of the axillary nerve. Medial head received two branches arising from the radial nerve in 34 (94%) specimens. One (3%) specimen received three branches from the radial nerve whereas one (3%) had dual supply from the radial and ulnar nerves. Lateral head received multiple branches exclusively from the radial nerve, ranging from 2 to 5, in all (100%) specimens. Knowledge of the variations in innervation of the triceps would not only help the surgeon to avoid inadvertent injury to any of the nerve branches but also offers new options for nerve and free functional muscle transfers.

摘要

肱三头肌的神经支配模式复杂,尚未完全被理解。不同作者描述过肱三头肌的异常神经支配情况。我们试图描绘肱三头肌的神经供应,并记录其不同头的异常神经支配。在36具防腐处理的尸体上肢中,解剖了臂丛神经及其主要分支(在腋窝和手臂区域)以及肱三头肌。在31例(86%)标本中,肱三头肌长头从桡神经接收1支。4例(11%)标本接收2支,其中1支有来自桡神经和腋神经的双重支配,1例(3%)标本仅由腋神经的1支支配。在34例(94%)标本中,肱三头肌内侧头从桡神经接收2支。1例(3%)标本从桡神经接收3支,而1例(3%)由桡神经和尺神经双重供应。在所有(100%)标本中,肱三头肌外侧头仅从桡神经接收多支分支,范围从2支到5支。了解肱三头肌神经支配的变异不仅有助于外科医生避免意外损伤任何神经分支,还为神经和游离功能性肌肉转移提供了新的选择。

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本文引用的文献

1
Variations in the Innervation of the Long Head of the Triceps Brachii: A Cadaveric Investigation.
Clin Orthop Relat Res. 2017 Jan;475(1):247-250. doi: 10.1007/s11999-016-5146-z. Epub 2016 Nov 9.
2
Axon Counts Yield Multiple Options for Triceps Fascicular Nerve to Axillary Nerve Transfer.
J Hand Surg Am. 2016 Nov;41(11):e405-e410. doi: 10.1016/j.jhsa.2016.07.110. Epub 2016 Aug 28.
3
Triceps innervation pattern: implications for triceps nerve to deltoid nerve transfer.
Biomed Res Int. 2013;2013:132954. doi: 10.1155/2013/132954. Epub 2013 Dec 30.
5
Ulnar nerve innervation of the medial head of the triceps brachii muscle: a cadaveric study.
Clin Anat. 2013 Nov;26(8):1028-30. doi: 10.1002/ca.22270. Epub 2013 May 29.
6
Ulnar nerve innervation of the triceps muscle: real or apparent? An anatomic study.
Clin Orthop Relat Res. 2013 Jun;471(6):1887-93. doi: 10.1007/s11999-012-2768-7. Epub 2013 Jan 3.
7
Surgical anatomy of the radial nerve branches to triceps muscle.
Clin Anat. 2013 Apr;26(3):386-91. doi: 10.1002/ca.22174. Epub 2012 Oct 4.
9
A cadaveric study of ulnar nerve innervation of the medial head of triceps brachii.
Clin Orthop Relat Res. 2009 Jan;467(1):235-8. doi: 10.1007/s11999-008-0535-6. Epub 2008 Oct 11.

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