WellStar Medical Group, Atlanta, Georgia, USA.
Indiana University School of Medicine, Indiana, USA.
J Hand Surg Eur Vol. 2020 Mar;45(3):237-241. doi: 10.1177/1753193419889280. Epub 2019 Dec 2.
We investigated whether motor fascicles of the ulnar nerve can be reliably identified proximal to the wrist. In 17 cadaveric upper limbs, the anterior interosseous nerve was transected at its arborization in the pronator quadratus and transposed to the palmar aspect of the ulnar nerve. The motor fascicular bundle was identified at this level after distinguishing the intraneural epineural involution by microsurgical probing. The motor branch was identified in Guyon's canal and traced retrograde via intraneural dissection to assess accuracy of the original identification. The motor fascicular bundle was found to have been correctly identified in all specimens. We conclude that local anatomic landmarks allow for the motor fascicular group to be correctly identified. Therefore, retrograde, internal dissection of the ulnar nerve is not likely to be required for reliable transfer of anterior interosseous nerve to ulnar nerve motor fascicles.
我们研究了尺神经的运动束在腕部近端是否可以可靠地识别。在 17 具尸体上肢中，在前旋肌切开其分支处切断正中神经，并将其转位到尺神经的掌侧。通过显微外科探查，在区分神经内神经外萎缩后，在此水平识别运动束。在 Guyon 管中识别运动支，并通过神经内解剖逆行追踪，以评估原始识别的准确性。在所有标本中均发现运动束已被正确识别。我们得出结论，局部解剖标志可正确识别运动束群。因此，对于可靠地将正中神经前骨间神经转移到尺神经运动束，逆行、内部解剖尺神经不太可能是必需的。
