Kobayashi Shunsuke, Miyake Satoshi, Shibata Terufumi, Matsunaga Kei, Hata Naofumi, Izaki Teruaki, Yamamoto Takuaki
Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Department of Orthopaedic Surgery, Fukuoka University Chikushi Hospital, Chikushino, JPN.
Cureus. 2024 Jul 8;16(7):e64119. doi: 10.7759/cureus.64119. eCollection 2024 Jul.
In recent years, intramedullary nails with medial support screws for proximal humeral fractures have become available. Although these devices have a potential risk of iatrogenic axillary nerve injury, no studies have investigated the anatomical relationship between the medial support screws in the modern intramedullary nail and the axillary nerve. This study aimed to clarify the anatomical relationship between the medial support screws in the intramedullary nail and the axillary nerve.
In total, 29 cadaveric shoulders (mean age: 82.6 years old (range: 61-105); 15 males and 14 females) were included in this study. Shoulders within whole-body cadavers were used in all cases. A single proximal humeral nail with medial support screws (ARISTO Proximal Humeral Nail; MDM, Tokyo, Japan) was used. The distance of each medial support screw from the axillary nerve and its branches was measured.
In two (6.90%) of 29 shoulders, the axillary nerves came into contact with the medial support screws. In the remaining 27 of 29 shoulders (93.1%), the nerves were located proximal to the medial support screws.
Medial support screws in proximal humeral fracture nails had the potential to injure the axillary nerve and its branches.
近年来，用于肱骨近端骨折的带有内侧支撑螺钉的髓内钉已面市。尽管这些器械存在医源性腋神经损伤的潜在风险，但尚无研究调查现代髓内钉中的内侧支撑螺钉与腋神经之间的解剖关系。本研究旨在阐明髓内钉中的内侧支撑螺钉与腋神经之间的解剖关系。
本研究共纳入29具尸体肩部标本（平均年龄：82.6岁（范围：61 - 105岁）；男性15例，女性14例）。所有病例均使用全身尸体上的肩部标本。使用一枚带有内侧支撑螺钉的肱骨近端髓内钉（ARISTO近端肱骨钉；MDM，日本东京）。测量每枚内侧支撑螺钉与腋神经及其分支的距离。
在29个肩部标本中的2个（6.90%），腋神经与内侧支撑螺钉接触。在其余27个肩部标本（93.1%）中，神经位于内侧支撑螺钉的近端。
肱骨近端骨折髓内钉中的内侧支撑螺钉有可能损伤腋神经及其分支。
