Prasartritha T, Liupolvanish P, Rojanakit A
Department of Orthopaedics, Lerdsin General Hospital, Bangkok, Thailand.
J Hand Surg Am. 1993 Jan;18(1):107-12. doi: 10.1016/0363-5023(93)90253-Y.
Sixty fresh cadaver upper extremities were dissected for a study of the course of the posterior interosseous nerve (PIN) in the radial tunnel, an area that varies but begins in the furrow between the brachioradialis and brachialis in the distal arm and ends at the distal edge of the supinator muscle in the proximal forearm. The radial nerve pierces the lateral intermuscular septum 13 cm above the elbow joint line. At 1.3 cm above the joint line the nerve divides into its posterior interosseous and superficial radial branches. The extensor carpi radialis brevis muscle received nerve supply from the superficial radial nerve, radial nerve, and PIN in 43%, 55%, and 2%, respectively. The PIN passed through the radial tunnel anterior to the radiohumeral joint and then coursed laterally and posteriorly beneath the arcade of Frohse, which is the proximal edge of the superficial layer of the supinator muscle. The arcade was tendinous in 57% of the cadavers and membranous in 43%. The distal edge of the supinator was tendinous in 65% of the specimens and membranous in 35%. The purpose of this article was to measure the various lengths of the PIN and to study possible compression sites at normal variations along the course of the PIN in the radial tunnel. No cases showed evidence of PIN compression in the radial tunnel.
为研究骨间后神经(PIN)在桡管内的走行,对60具新鲜尸体上肢进行了解剖。桡管区域存在变异,起于上臂远端肱桡肌与肱肌之间的沟内,止于前臂近端旋后肌的远端边缘。桡神经在肘关节线以上13 cm处穿经外侧肌间隔。在关节线以上1.3 cm处,神经分为骨间后支和桡神经浅支。桡侧腕短伸肌分别接受来自桡神经浅支、桡神经和骨间后神经的神经支配,比例分别为43%、55%和2%。骨间后神经在桡肱关节前方穿过桡管,然后在旋后肌浅层近端边缘即弗罗瑟弓下方横向和向后走行。在57%的尸体中,弗罗瑟弓为腱性,43%为膜性。在65%的标本中,旋后肌远端边缘为腱性,35%为膜性。本文的目的是测量骨间后神经的不同长度,并研究在桡管内骨间后神经走行过程中正常变异情况下可能的卡压部位。在桡管内未发现骨间后神经受压的病例。