Duval M J, Parker A W, Drez D, Hinton M A
Louisiana State University School of Medicine, New Orleans.
Orthop Rev. 1993 Sep;22(9):1023-6.
The anatomic relationship between the anterior humeral circumflex vessels and the axillary nerve was studied in 24 fresh-frozen cadaveric four-quarter shoulder specimens. Each shoulder was exposed through a standard deltopectoral incision, and the axillary nerve, anterior humeral circumflex vessels, and bicipital groove were identified. The perpendicular distance from the medial border of the bicipital groove to a point where the vessels crossed anterior to the nerve measured 2.6 +/- 0.4 cm (range, 2.1-3.6 cm). The perpendicular distance from the medial aspect of the bicipital groove to the point where the axillary nerve crossed the inferior border of the subscapularis and thus entered the quadrangular space was 3.0 +/- 0.5 cm (range, 2.1-4.4 cm). The anterior humeral circumflex vessels were easily located in all specimens, and the axillary nerve could be identified by its relationship to the vessels as described above, thus providing the operating surgeon with a consistent and reliable method of recognizing this nerve during anterior shoulder procedures. In addition, the axillary nerve was palpable in all specimens by sweeping the index finger in a medial-to-lateral direction along the inferior border of the subscapularis.
在24个新鲜冷冻的尸体四分之一肩部标本中研究了旋肱前血管与腋神经之间的解剖关系。每个肩部通过标准的三角肌胸大肌切口暴露，识别腋神经、旋肱前血管和肱二头肌沟。从肱二头肌沟内侧缘到血管在神经前方交叉点的垂直距离为2.6±0.4厘米（范围为2.1 - 3.6厘米）。从肱二头肌沟内侧到腋神经穿过肩胛下肌下缘从而进入四边孔处的垂直距离为3.0±0.5厘米（范围为2.1 - 4.4厘米）。在所有标本中旋肱前血管都很容易定位，并且腋神经可通过其与上述血管的关系来识别，从而为手术医生在前肩部手术过程中识别该神经提供了一种一致且可靠的方法。此外，通过沿肩胛下肌下缘从内侧向外侧方向扫动食指，在所有标本中都可摸到腋神经。
