Caetano Edie Benedito, Vieira Luiz Angelo, Sabongi Neto João José, Caetano Maurício Benedito Ferreira, Picin Celis Piovesan, Silva Júnior Luiz Claudio Nascimento da
Departamento de Cirurgia, Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (FCMS/PUC-SP), Sorocaba, SP, Brasil.
Serviço de Cirurgia da Mão, Conjunto Hospitalar de Sorocaba, Sorocaba, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2020 Dec;55(6):764-770. doi: 10.1055/s-0040-1713403. Epub 2020 Dec 18.
To analyze the anatomical variations of the motor branches of the radial nerve in the elbow region. The origin, course, length, branches, motor points and relationships with neighboring structures were evaluated. Thirty limbs from15 adult cadavers were dissected and prepared by intra-arterial injection of a 10% glycerin and formaldehyde solution. The first branch of the radial nerve in the forearm went to the brachioradialis muscle (BR), originating proximally to the division of the radial nerve into superficial branch of the radial nerve (SBRN) and posterior interosseous nerve (PIN) in all limbs. The branches to the extensor carpi radialis longus muscle (ECRL) detached from the proximal radial nerve to its division into 26 limbs, in 2, at the dividing points, in other 2, from the PIN. In six limbs, the branches to the BR and ECRL muscles originated from a common trunk. We identified the origin of the branch to the extensor carpi radialis brevis muscle (ECRB) in the PIN in 14 limbs, in the SBRN in 12, and in the radial nerve in only 4. The branch to the supinator muscle originated from the PIN in all limbs. Knowledge of the anatomy of the motor branches of the radial nerve is important when performing surgical procedures in the region (such as the approach of the proximal third and the head of the radius, release of compressive syndromes of the posterior interosseous nerve and radial tunnel, and distal nerve transfers) in order to understand the order of recovery of muscle function after a nerve injury.
分析桡神经运动支在肘部区域的解剖变异情况。评估其起源、走行、长度、分支、运动点以及与相邻结构的关系。
对15具成年尸体的30条上肢进行解剖，并通过动脉内注射10%甘油和甲醛溶液进行标本制备。
前臂桡神经的第一分支支配肱桡肌（BR），在所有上肢中，其起源均在桡神经分为桡神经浅支（SBRN）和骨间后神经（PIN）的近端。支配桡侧腕长伸肌（ECRL）的分支在26条上肢中从桡神经近端发出至其分支处，在2条上肢中在分支点处发出，在另外2条上肢中从PIN发出。在6条上肢中，支配BR和ECRL肌的分支起源于一个共同的干。我们发现，在14条上肢中，支配桡侧腕短伸肌（ECRB）的分支起源于PIN，在12条上肢中起源于SBRN，仅在4条上肢中起源于桡神经。支配旋后肌的分支在所有上肢中均起源于PIN。
了解桡神经运动支的解剖结构对于在该区域进行手术操作（如桡骨近端三分之一和桡骨头的入路、骨间后神经和桡管压迫综合征的松解以及远端神经移位）非常重要，以便理解神经损伤后肌肉功能恢复的顺序。
