摘要
目的对肘前内侧血管神经等相关结构进行解剖研究,为肘关节相关手术提供更佳的手术入路。方法福尔马林防腐动脉灌注红色乳胶成人尸体上肢标本20侧,按层次解剖,从肱桡肌及旋前圆肌间隙进入,通过正中神经与肱、尺动脉之间的血管神经间隙,显露肘前侧解剖结构。观察肱动脉、桡动脉和尺动脉向内、外侧的分支,测量分支到桡、尺动脉分叉处的距离,分支管径;观察正中神经及分支走行情况,测量神经与血管伴行无相互交叉分支距离。结果血管神经无互相交叉分支伴行长度平均为6.04 cm,两者之间无重要分支相交叉,易于向两侧分开,能够清楚地提供肘关节相应部位的暴露。动脉向内侧分支较向外侧分支少且细,易于向外侧牵拉。神经肌支,基本上向内侧发出,以极小的锐角从主干发出,几乎与主干平行,易于向内侧牵拉。结论肘前内侧血管神经间隙入路,可保护血管神经,能清楚显露肘关节前侧解剖结构,易于操作。
Objective To study the anatomy of anterior neurovascular and relevant structures of the elbow to provide better surgical approach for the elbow. Method The upper extremities of 10 adult cadavers that were fixed by formaldehyde and perfused with latex from the artery, were dissected for observation of anatomic structures of the anteromedial approach of the elbow. Dissection was performed first in the space between the brachioradialis and the pronator teres to access the neurovascular interval between the medial nerve, and the brachial artery and ulnar artery, though which the median nerve and the brachial artery, radial artery and ulnar artery and their branches were exposed. The radial branches of artery and their diameter in themselves and the ulnar branches of artery were observed and measured, the distance between these branches and the fork of radial and ulnar artery were measured, the median and its branches anatomical characteristics and the distance of no intersecting branches between nerve and artery were observed and measured. Results There was no intersecting branches between the median nerve and brachial artery and its average length was 6.04 cm, and the interval between the median nerve and brachial artery was loose and easy to be retracted. The medial branches of the artery were smaller in number and diameter than the lateral branches of the artery, making it easy to retract the artery laterally. The branches of the median nerve almost all extended medially, and the angle between the branch and the main trunk was very small, making them almost parallel. Therefore, the medial retraction of the median nerve can be easy. Conclusion The anterior anatomical structures of the elbow can be clearly and easily exposed through the anteromedial neurovascular interval approach, and the vessel and nerve can be protected.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2017年第2期126-129,共4页
Chinese Journal of Clinical Anatomy
基金
河北省承德市科技支撑计划项目(20157035)
关键词
手术入路
肘前内侧入路
血管神经间隙
应用解剖
Surgical approach
Anteromedial approach of elbow
Neurovascular interval
Applied anatomy
