Trowbridge S, Sagmeister M L, Lewis T L, Vidakovic H, Hammer N, Kieser D C
Guy's and St Thomas' NHS Foundation Trust, Maze Pond, London, SE1 9RT, UK.
Trauma and Orthopaedic Department, Maidstone and Tunbridge Wells NHS Trust, Tonbridge Road, Royal Tunbridge Wells, TN2 4QJ, UK.
J Clin Orthop Trauma. 2022 Apr 12;28:101868. doi: 10.1016/j.jcot.2022.101868. eCollection 2022 May.
The anterior interosseous nerve (AIN) is a terminal motor branch of the median nerve innervating the following three muscles from proximal to distal: Flexor pollicis longus (FPL), the radial half of flexor digitorum profundus (FDP), and the pronator quadratus (PQ). The aim of this study was to define the course of the AIN within the PQ to aid surgeons performing distal radial procedures.
Ten embalmed cadaveric forearms were dissected to identify the path of the AIN within PQ. An en-bloc excision of the PQ with its supplying AIN and vasculature was performed to identify a safe zone where PQ can be elevated without damaging AIN. A scoping literature search was performed to identify other studies reporting the path of AIN through PQ.
The mean distance from the radial border of the radius perpendicular to the point at which the AIN enters the PQ was 22.3 mm (range 21-24 mm). The mean distance from the distal wrist crease to the AIN entering PQ was 74.3 mm (range 59-84 mm). The mean number of nerve branches to PQ was 5.2 (range 3-8). In all specimens, the AIN was found to lie on the radial side of the anterior interosseous artery (AIA).
The AIN courses on the deep surface of the PQ in a longitudinal proximal to distal direction. A 'safe zone' was identified within 20 mm of the radial border of the distal radius, which may be utilised by surgeons in a muscle-splitting approach to the distal radius.
骨间前神经（AIN）是正中神经的终末运动支，从近端到远端支配以下三块肌肉：拇长屈肌（FPL）、指深屈肌的桡侧半（FDP）和旋前方肌（PQ）。本研究的目的是明确AIN在PQ内的走行，以帮助外科医生进行桡骨远端手术。
解剖10具防腐处理的尸体前臂，以确定AIN在PQ内的路径。对PQ及其供应的AIN和血管进行整块切除，以确定一个安全区域，在该区域可在不损伤AIN的情况下抬起PQ。进行了文献综述，以确定其他报道AIN通过PQ路径的研究。
从桡骨桡侧缘垂直至AIN进入PQ点的平均距离为22.3mm（范围21 - 24mm）。从腕横纹远端至AIN进入PQ的平均距离为74.3mm（范围59 - 84mm）。至PQ的神经分支平均数量为5.2（范围3 - 8）。在所有标本中，AIN均位于骨间前动脉（AIA）的桡侧。
AIN在PQ深面沿近端至远端纵向走行。在桡骨远端桡侧缘20mm范围内确定了一个“安全区域”，外科医生在采用肌肉劈开入路处理桡骨远端时可利用该区域。
