背景:许多手术策略旨在治疗radium神经浅支(SBRN)的症状性神经瘤。尽管许多尝试揭示手术治疗失败的原因,但仍然难以治疗。已知前臂外侧皮神经(LACN)与SBRN重叠并连通。我们的研究旨在通过显微镜解剖来确定LACN纤维扩散到SBRN分支中的频率,以预测LACN纤维可能参与SBRN神经瘤的位置和频率。
方法:彻底解剖了87具尸体前臂。使用显微解剖确定LACN纤维通过SBRN分支的路径。测量了茎突线与LACN纤维进入SBRN以及SBRN的出现点和分叉点之间的距离。
结果:LACN纤维在茎间线近侧的平均距离为1.7±2.5cm处与SBRN连接。在62%的病例中,SBRN含有来自LACN的纤维。最常见的是,SBRN的第三分支中有LACN光纤(59%),但它们也在第一个分支中被观察到,第二个分支,和他们共同的躯干(21%,9.2%,22%,分别)。在SBRN主干内发现LACN纤维的最低比率(6.9%)。
结论:在几乎2/3的病例中,SBRN含有LACN纤维,因此,治疗神经瘤可能需要去神经支配。然而,该方法必须根据特定的临床情况来考虑。
BACKGROUND: Many surgical strategies aim to treat the symptomatic neuroma of the superficial branch of the radial nerve (SBRN). It is still difficult to treat despite many attempts to reveal a reason for surgical treatment failure. The lateral antebrachial cutaneous nerve (LACN) is known to overlap and communicate with SBRN. Our study aims to determine the frequency of spreading of LACN fibers into SBRN branches through a microscopic dissection to predict where and how often LACN fibers may be involved in SBRN neuroma.
METHODS: Eighty-seven cadaveric forearms were thoroughly dissected. The path of LACN fibers through the SBRN branching was ascertained using microscopic dissection. Distances between the interstyloid line and entry of LACN fibers into the SBRN and emerging and bifurcation points of the SBRN were measured.
RESULTS: The LACN fibers joined the SBRN at a mean distance of 1.7 ± 2.5 cm proximal to the interstyloid line. The SBRN contained fibers from the LACN in 62% of cases. Most commonly, there were LACN fibers within the SBRN\'s third branch (59%), but they were also observed within the first branch, the second branch, and their common trunk (21%, 9.2%, and 22%, respectively). The lowest rate of the LACN fibers was found within the SBRN trunk (6.9%).
CONCLUSIONS: The SBRN contains LACN fibers in almost 2/3 of the cases, therefore, the denervation of both nerves might be required to treat the neuroma. However, the method must be considered based on the particular clinical situation.