Kim Jeong Min, Kim Byungjun, Yoon Joon Shik
Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Ann Rehabil Med. 2022 Aug;46(4):185-191. doi: 10.5535/arm.22071. Epub 2022 Aug 31.
To demonstrate the sonoanatomy of the medial antebrachial cutaneous nerve (MACN) in the elbow region using high-resolution ultrasonography (HRUS) to identify areas at a high risk of MACN injury.
A total of 44 arms were included in the study. In the supine position, the participants' arms were abducted 45° with the elbow fully extended. The MACN was visualized in the transverse view. The anterior branch of the MACN (ABMACN), posterior branch of the MACN (PBMACN), and location of the branching sites were determined. The distance between the ABMACN and superficial veins, including the basilic vein (BV) and median cubital veins (MCV) was measured. For the PBMACN, the distance to the ulnar nerve (UN) and to BV were measured.
The MACN was subdivided into 2.18±1.00 branches, including ABMACN and PBMACN. The ABMACN and PBMACN were subdivided into 1.60±0.78 and 1.07±0.25 branches, respectively. The branching point of the MACN was 8.40±2.42 cm proximal to the interepicondylar line (IEL). We demonstrated that the ABMACN is located close to the BV and MCV in the elbow region, and the PBMACN was located approximately 1 cm and 0.8 cm anterior to the UN and posterior to the BV at the IEL level, respectively.
Considering the location of the MACN, including ABMACN and PBMACN, clinicians can perform invasive procedures around the elbow region more carefully to lower the risk of MACN injury.
使用高分辨率超声（HRUS）展示肘区臂内侧皮神经（MACN）的超声解剖结构，以识别MACN损伤的高风险区域。
本研究共纳入44条手臂。参与者仰卧位，手臂外展45°，肘部完全伸直。在横断面上观察MACN。确定MACN的前支（ABMACN）、后支（PBMACN）及其分支部位。测量ABMACN与浅静脉（包括贵要静脉（BV）和肘正中静脉（MCV））之间的距离。对于PBMACN，测量其与尺神经（UN）及BV之间的距离。
MACN分为2.18±1.00支，包括ABMACN和PBMACN。ABMACN和PBMACN分别分为1.60±0.78支和1.07±0.25支。MACN的分支点位于髁间线（IEL）近端8.40±2.42 cm处。我们发现，在肘区ABMACN靠近BV和MCV，在IEL水平PBMACN分别位于尺神经前方约1 cm处和BV后方约0.8 cm处。
考虑到MACN（包括ABMACN和PBMACN）的位置，临床医生在肘区周围进行侵入性操作时可更加谨慎，以降低MACN损伤的风险。
