Park Kwan Jun, Romero Brandon Anthony, Ahmadi Shahryar
Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
University of Nevada, Reno School of Medicine, Division of Orthopaedic Surgery, Las Vegas, NV, USA.
Arch Bone Jt Surg. 2019 May;7(3):246-250.
Several studies have identified the radial nerve in arm using different anatomic landmarks, however, a controversy remains. Deltoid tuberosity (DT) and brachioradialis (BR) are reproducible landmarks that can be used to identify the radial nerve (RN) during fracture surgery.
Dissection of RN was carried out in 17 fresh frozen adult cadavers. Using a calibrated caliper, we measured the distance between DT and the origin of BR. The distance between DT and where RN becomes lateral in its relationship with the humerus (DT-RN) and the distance between RN and BR (RN-BR) were subsequently measured. The ratio of DT-RN to DT-BR was calculated to see where the nerve lies in relationship to DT-BR.
Average DT-BR was 81.8 (±14.86) mm, average DT-RN was 48.9 (± 7.83) mm, and average RN-BR was 33.0 (± 10.16) mm. RN was always found posterior to DT and was never found in the proximal third of DT-BR. The nerve was found in the middle third of DT-BR in 14 of 17 cadavers (82.4 %) and in the distal third in 3 out of 17 cadavers (17.6%). 16 of 17 cadavers (94%) had radial nerve in the distal half of DT-BR.
Using the anatomic relationships between RN, DT, and the origin of BR, identification of RN is easily reproducible. These two structures can serve as the stationary landmarks during fracture surgery to find the radial nerve, which can be found in the distal 2/3 of the distance between the deltoid tuberosity and the origin of brachioradialis.
V.
多项研究利用不同的解剖标志来识别臂部的桡神经，但仍存在争议。三角肌粗隆（DT）和肱桡肌（BR）是可重复的标志，可用于在骨折手术中识别桡神经（RN）。
对17具新鲜冷冻的成年尸体进行桡神经解剖。使用校准卡尺，我们测量了DT与BR起点之间的距离。随后测量了DT与桡神经在与肱骨关系中外侧化处之间的距离（DT-RN）以及桡神经与BR之间的距离（RN-BR）。计算DT-RN与DT-BR的比值，以了解神经相对于DT-BR的位置。
DT-BR的平均距离为81.8（±14.86）mm，DT-RN的平均距离为48.9（±7.83）mm，RN-BR的平均距离为33.0（±10.16）mm。桡神经总是位于DT的后方，从未在DT-BR的近端三分之一处发现。在17具尸体中的14具（82.4%）中，神经位于DT-BR的中间三分之一处，在17具尸体中的3具（17.6%）中位于远端三分之一处。17具尸体中的16具（94%）在DT-BR的远端一半有桡神经。
利用桡神经、三角肌粗隆和肱桡肌起点之间的解剖关系，桡神经的识别很容易重复。这两个结构可作为骨折手术中寻找桡神经的固定标志，桡神经可在三角肌粗隆与肱桡肌起点之间距离的远端2/3处找到。
V级。
