骨间后神经桡管段的解剖学观测和临床意义.docVIP

骨间后神经桡管段的解剖学观测和临床意义 张廷才, 司道文, 张宇新华北煤炭医学院基础部解剖学教研室河北 唐山　063000目的探讨桡骨头颈部手术的安全区，并为骨间后神经卡压综合的手术治疗提供解剖学资料。 方法在80侧上肢标本上解剖观测骨间后神经桡管段的行程毗邻和可能存在的卡压部位。 结果在桡内骨间后神经在桡骨头前方附近自桡神经发出，隔肘关节囊、环状韧带越过肱骨小头、桡骨头行至桡骨颈外侧中线处与桡骨颈交叉。该交叉部位距桡骨上缘3.6±0.4 cm，是骨间后神经由前、上、内转向后、下、外的转折点，且与骨面紧贴；桡侧返血管的分支、桡侧腕短伸肌腱弓均对骨间后神经形成卡压。结论桡骨上端后外侧3.0 cm范围是桡骨头颈骨折手术暴露放置钢板的安全区；在行骨间后神经减压术，切开Frohse腱弓的同时，将桡侧返血管的分支和桡侧腕短伸肌腱弓一并处理。 骨间后神经；管；卡压综合The anatomic observation and clinical significance of the posterior interosseous nerve in the radial tunel part Zhang Tingcai, Si Daowen, Zhang Yuxin. (Department of Anatomy, School of Basic Medicine,North China Coal Medical College. Tangshan 063000, China) Abstract Objective To explore the safe zones of operation in head and neck of radius and to provide anatomical data for the surgical treatment. Methods 80 posterior interosseous nerves were detected. The relationship and the compression of the radial tunel part were observed. Results The radial nerves gave off posterior interosseous nerves in the radial tunel part in front of head of radius. Posterior interosseous nerves crossed the 作者简介： 张廷才（1951-），男，汉族，河北唐山人，硕士，副教授，从事方面的研究。 Tel 0315-3725753，E-mail: sidaowen@072761390） humerus and head of radius, and descended lateral neck of radius and intersected with the neck of radius. The intersecting part was about (3.6±0.4) cm with the distance of the upper border of the radius. Posterior interosseous nerves next to the radial bone went from anterior and upper and medial to posterior and lower and lateral. The branch of the posterior interosseous nerves were compressed by the branch of radial returning vessel and the extensor carpi radialis brevis. Conclusions The posterolateral aspect of the radial head with the range 3.0 cm is the safe zones for the operation of radial head and neck. When operating with posterior interosseous nerve and cutting Frohse, we should treat the branch of radial returning vessel and the extensor carpi radialis brevis. Key words Posterior inter