Tozello Victor Ney Nunes, Volpiani Tulio Stefanin, Silva Vitor Luiz Mansur, Amaral Sergio Aparecido DO, Vieira Luiz Angelo, Caetano Edie Benedito
Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (PUC), São Paulo, Brazil.
Faculdade de Ciências Médicas e da Saúde, Department of Surgery, Pontifícia Universidade Católica de São Paulo (PUC), São Paulo, Brazil.
Acta Ortop Bras. 2023 Jul 31;31(4):e265467. doi: 10.1590/1413-785220233104e265467. eCollection 2023.
This study aims to present lines A1 and A2 in association with Kaplan's cardinal line (LCK), and relate them to the thenar motor branch of the median nerve (RMTNM) and to the deep branch of the ulnar nerve (RPNU).
Ten hands of five adult cadavers were dissected.
The RMTNM origin was positioned proximal to the LCK in all limbs. In two, the RMTNM was positioned exactly on the A1 line; in seven, it was on the ulnar side in relation to A1. In one, it was on the radial side relative to the A1. The origin of the RPNU was identified between the pisiform and the LCK in nine limbs; in one, the RPNU was positioned from the ulnar nerve in relation to A2; and in two, the A2 passed exactly at the point of division of the ulnar nerve into superficial branches and deep. We did not identify the positioning of the RPNU on the radial side of the A2 line.
The impact of this study was to identify the anatomical trajectory of these nerves by detaching A1 and A2 along with the KCL, avoiding iatrogenic lesions during surgical procedures.
本研究旨在呈现A1线和A2线与卡普兰主线（LCK）的关联，并将它们与正中神经的鱼际运动支（RMTNM）及尺神经深支（RPNU）联系起来。
解剖了5具成年尸体的10只手。
在所有肢体中，RMTNM的起点均位于LCK的近端。其中2只手上，RMTNM恰好位于A1线上；7只手上，它位于A1线的尺侧；1只手上，它位于A1线的桡侧。9只肢体中，RPNU的起点位于豌豆骨与LCK之间；1只手上，RPNU从尺神经发出，与A2相关；2只手上，A2恰好经过尺神经分成浅支和深支的分叉点。我们未发现RPNU位于A2线桡侧的情况。
本研究的意义在于通过分离A1和A2以及KCL来确定这些神经的解剖走行，避免手术过程中的医源性损伤。
