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桡神经与腋窝后壁之间肩胛下动脉的卡压:一种具有临床意义的解剖变异

Entrapment of the Subscapular Artery between the Radial Nerve and the Posterior Wall of the Axilla: An Anatomical Variation with Clinical Significance.

作者信息

Daskalopoulou Dimitra, Chrysikos Dimosthenis, Samolis Alexandros, Tsakotos George, Shihada Amir, Piagkou Maria, Troupis Theodore

机构信息

Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Department of Plastic and Reconstructive Surgery, Naval Hospital Athens, Athens, Greece.

Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Acta Med Acad. 2024 Aug;53(2):188-192. doi: 10.5644/ama2006-124.435.

Abstract

OBJECTIVE

The subscapular artery vascularizes a substantial region of the thoracic wall, and the significance of its distribution is well depicted in the diversity of reconstructive procedures that rely on its blood supply. The aim of this study is to present an uncommon anatomical variation of the artery and discuss the clinical implications of its presence.

CASE REPORT

This case report depicts a rare variant of compression and the kinking of the subscapular artery by the radial nerve on the posterior wall of the axilla that was encountered during dissection of a male cadaver of Greek origin.

CONCLUSION

The use of autologous tissues in the reconstruction of defects and treatment of lymphedema is expanding, so the need to establish safer surgical dissections is also becoming more apparent. The case of entrapment of the subscapular artery by the radial nerve is extremely rare, however, utilizing tissues perfused by this artery for reconstructive purposes could potentially be futile and unsuccessful due to the inadequate blood supply or vessel thrombosis. Hence, the surgeon should adapt the treatment plan according to preoperative findings, as the presence of anatomical variants should always be suspected.

摘要

目的

肩胛下动脉为胸壁的大片区域供血,其分布的重要性在依赖其血供的多种重建手术中得到了充分体现。本研究旨在呈现该动脉一种不常见的解剖变异,并探讨其存在的临床意义。

病例报告

本病例报告描述了在一具希腊裔男性尸体解剖过程中遇到的一种罕见变异情况,即腋后壁的桡神经对肩胛下动脉造成压迫和扭曲。

结论

自体组织在缺损修复和淋巴水肿治疗中的应用正在不断扩大,因此建立更安全手术解剖方法的需求也日益明显。桡神经压迫肩胛下动脉的情况极为罕见,然而,由于血供不足或血管血栓形成,利用该动脉供血的组织进行重建可能徒劳无功且无法成功。因此,外科医生应根据术前检查结果调整治疗方案,因为始终应怀疑存在解剖变异情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e576/11626243/e191e8c4eead/AMA-53-188-g001.jpg

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