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目的探讨前臂近中段Thompson入路中容易发生桡神经深支损伤的解剖学因素并提出对策。方法教学用成人尸体标本48具,按照Thompson入路显露,观察前臂伸肌与桡神经深支及其肌支的位置关系;测量桡神经深支穿出旋后肌的位置距离桡侧腕短伸肌的横向距离;观察指伸肌和桡侧腕短伸肌在前臂近段的愈着情况,测量二者在肱桡关节线以远的愈着长度。结果指伸肌和桡侧腕短伸肌在前臂近段相愈着,愈着长度在肱桡关节以远(7.1±2.1)cm;桡神经深支在旋后肌下缘的穿出点与桡侧腕短伸肌尺侧缘的水平距离为(1.3±0.3)cm,与肱桡关节线距离为(6.1±1.8)cm。结论前臂近中段Thompson入路中容易发生桡神经深支损伤存在着解剖学因素,了解桡神经深支的解剖特点及其与前臂伸肌的位置关系可以避免桡神经深支损伤。
Objective To investigate the anatomical factors that may cause deep radial nerve injury in Thompson approach of the proximal forearm. Methods Forty-eight adult cadavers were instrumented. According to the Thompson approach, the relationship between the forearm extensor and the deep branch of radial nerve and its muscular branch was observed. The position of the deep branch of the radial nerve penetrating the posterior spinous muscle was measured. Muscle lateral distance; refers to the extensor and radial extensor wrist extensor in the proximal forearm healing, measuring both in the brachiorad Radial joint line longer than the length. The results showed that the extensor and radial extensor carpius were more proximal to the forearm, and the longer the extensor digitorum longus was (7.1 ± 2.1) cm. The horizontal distance between the lateral extensors of the extensors was (1.3 ± 0.3) cm and the distance between the brachialis and the extensor joints was (6.1 ± 1.8) cm. Conclusion There are anatomical factors prone to the deep branch injuries of radial nerve in the proximal forearm midrib Thompson approach. Understanding the anatomical features of the deep branch of the radial nerve and its relationship with the forearm extensors can avoid the deep branch injuries of the radial nerve.