Akdeniz Üniversitesi Tıp Fakültesi, Anatomi Anabilim Dalı, 07070 Kampüs, Antalya, Türkiye.
Jt Dis Relat Surg. 2023;34(1):190-195. doi: 10.52312/jdrs.2023.882. Epub 2023 Jan 6.
This study aims to examine the reliability of the old and new parameters in determining the axillary nerve safe area for surgical interventions in the proximal humerus by measuring the distances between the top of the humeral head, the top of the greater tuberosity, the base of the greater tuberosity, and the acromion and axillary nerve.
Between 2020 and 2022, a total of 52 shoulders of 26 fresh frozen male human cadavers (mean age: 46±25.5 years; range, 28 to 64 years), 26 right and 26 left were included. The deltopectoral approach was used. The intersection distances of the anterolateral end of the acromion, the top of the humeral head, the top of the tuberculum majus, and the base of the tuberculum majus with the N. axillaries were determined. All measurements were performed using the Microscribe® G2X.
The mean distance from the top of the tuberculum majus to the axillary nerve (shown as "A") was measured as 4.36±0.17 cm and 4±0.21 cm on the right and left, respectively. The mean distance from the center of the base of the tuberculum majus to the axillary nerve (shown as "B") was measured as 1.27±0.18 cm and 1.24±0.11 cm on the right and left, respectively. The mean distance from the apex of the humeral head to the axillary nerve (shown as "C") was measured as 6.15±0.39 cm and 5.89±0.34 cm on the right and left, respectively. The mean distance between the anterolateral end of the acromion (shown as "D") was measured as 6.15±0.39 cm and 5.89±0.34 cm on the right and left, respectively. There was a moderate positive correlation between distances A and B measured on the right and left side, respectively (r=0.484; p=0.012) (r=0.454; p=0.020).
A strong positive correlation was found between the distances A and B. The A, B, and C parameters had a weak correlation with parameter D. The anatomical parameters A and B was found to be less variable and more reliable than parameter D.
本研究旨在通过测量肱骨头顶部、大结节顶部、大结节底部以及肩峰与腋神经之间的距离，来检验旧参数和新参数在确定肱骨近端手术中腋神经安全区域的可靠性。
2020 年至 2022 年间，共纳入 52 例 26 名新鲜冷冻男性人体尸体的肩关节（平均年龄：46±25.5 岁；范围 28 至 64 岁），右肩 26 例，左肩 26 例。采用三角肌胸大肌入路。确定肩峰前外侧端、肱骨头顶部、大结节顶部和大结节底部与腋神经的交点距离。所有测量均使用 Microscribe® G2X 进行。
大结节顶部至腋神经的平均距离（记为“A”）右侧为 4.36±0.17cm，左侧为 4±0.21cm。大结节底部中心至腋神经的平均距离（记为“B”）右侧为 1.27±0.18cm，左侧为 1.24±0.11cm。肱骨头顶点至腋神经的平均距离（记为“C”）右侧为 6.15±0.39cm，左侧为 5.89±0.34cm。肩峰前外侧端的平均距离（记为“D”）右侧为 6.15±0.39cm，左侧为 5.89±0.34cm。右侧和左侧的 A 和 B 测量值之间存在中度正相关（r=0.484；p=0.012）（r=0.454；p=0.020）。
发现 A 和 B 之间存在强烈的正相关。A、B 和 C 参数与参数 D 之间存在弱相关。与参数 D 相比，参数 A 和 B 的解剖参数具有更小的变异性和更高的可靠性。
