Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.
International Evidence-Based Anatomy Working Group, Krakow, Poland.
Folia Morphol (Warsz). 2021;80(2):248-254. doi: 10.5603/FM.a2020.0049. Epub 2020 May 12.
The aim of this study was to create a safe zone for surgeons who perform procedures in the wrist to avoid iatrogenic damage to the median nerve (MN) by identifying anatomical landmarks using ultrasound (USG).
We measured the distances between the MN and two easily identifiable anatomical landmarks at the level of the proximal border of carpal ligament using USG.
A total of 57 volunteers (n = 114 upper limbs) were included in this study. Our main findings revealed that the distance from the flexor carpi radialis tendon to MN (FCR-MN) was 7.87 mm (95% confidence interval 7.37-8.37) and the distance from flexor carpi ulnaris tendon to MN (FCU-MN) was 19.09 mm (95% confidence interval 18.51-19.67).
The tendons of FCR and FCU are easily identifiable landmarks that can be distinguished using simple palpation. Based on our USG findings, the area around FCR should be carefully navigated to avoid iatrogenic injury to the MN during surgical procedures around the carpal tunnel.
本研究旨在通过超声（USG）识别腕部手术中避免医源性正中神经（MN）损伤的安全区域，确定解剖学标志。
我们使用 USG 测量腕横韧带近端边界水平处 MN 与两个易于识别的解剖标志之间的距离。
本研究共纳入 57 名志愿者（n = 114 侧上肢）。我们的主要发现表明，桡侧腕屈肌腱至 MN（FCR-MN）的距离为 7.87mm（95%置信区间 7.37-8.37），尺侧腕屈肌腱至 MN（FCU-MN）的距离为 19.09mm（95%置信区间 18.51-19.67）。
FCR 和 FCU 肌腱是易于识别的标志，可以通过简单的触诊来区分。根据我们的 USG 发现，在腕管周围的手术中，应仔细避开 FCR 周围区域，以避免 MN 的医源性损伤。
