目的:该研究概述了解剖标志,这些标志可能有助于外科医生识别前臂外侧皮神经(LABCN),以最大程度地减少肘窝手术过程中的神经损伤。
方法:解剖了28具新鲜尸体上肢。LABCN的过程是从肱二头肌肌腱(BT)的出现点到前臂中部。神经与BT的关系,外侧上髁(LE),前臂静脉,测量并记录了臂丛肌(BR)。
结果:LABCN在所有标本中都出现在BT的外侧,并在50%的尸体中在BT的顶部内侧交叉。所有尸体的前臂浅筋膜都很深。在LE的水平,神经位于BR内侧平均6.3±3.1mm处。LABCN与BR的内侧边界对齐,平均距离髁间线68mm。从LE到LABCN的平均距离为24.5±7.2mm。LABCN和前臂静脉在同一个深筋膜平面,平均距离LE47.6±5mm(37-55)。在肘关节处,82.1%的标本有两个分支为LABCN,而17.9%只显示一个分支。
结论:前臂外侧皮神经位于髁间线远端约6.8cm处,位于BR的尺骨边缘,并与前臂静脉平行延伸至前臂筋膜平面深处。在50%的标本中,神经越过二头肌肌腱。这些发现表明,神经应位于LE远端6-7厘米处,然后是近端夹层.
结论:这项研究可能有助于外科医生识别LABCN,降低LABCN损伤的潜在风险。
OBJECTIVE: The research outlines anatomical landmarks that may help surgeons in identifying the lateral antebrachial
cutaneous nerve (LABCN) to minimize nerve damage during procedures in the cubital fossa.
METHODS: Twenty-eight fresh cadaveric upper extremities were dissected. The course of the LABCN was followed from the emerging point at the biceps brachii tendon (BT) to the mid-forearm. The nerve\'s relationships with the BT, lateral epicondyle (LE), antebrachial vein, and brachioradialis (BR) muscle were measured and documented.
RESULTS: The LABCN emerged lateral to the BT in all specimens and crossed medially at the top of the BT in 50% of the cadavers. It was deep to the forearm superficial fascia in all cadavers. At the level of the LE, the nerve was located at a mean of 6.3 ± 3.1 mm medial to the BR. The LABCN aligns with the medial border of the BR at a mean of 68 mm distal to the interepicondylar line. The mean distance from the LE to the LABCN at the interepicondylar line was 24.5 ± 7.2 mm. The LABCN and antebrachial vein are in the same deep fascia plane, on average 47.6 ± 5 mm (37-55) from the LE. At the elbow joint level, 82.1% of the specimens have two branches for the LABCN, whereas 17.9% demonstrated only a single branch.
CONCLUSIONS: Lateral antebrachial
cutaneous nerve was situated approximately 6.8 cm distal to the interepicondyle line, positioned at the ulnar edge of the BR, and runs parallel with the antebrachial vein deep to the forearm fascia plane. The nerve crossed over the biceps tendon in 50% of the specimens. These findings suggest that the nerve should be identified 6-7 cm distal to the LE, followed by a proximal dissection.
CONCLUSIONS: This study may help surgeons in identifying LABCN, and reducing the potential risk of LABCN injury.