腋神经和桡神经与肱骨的关系及其临床意义

目的　观测腋神经、桡神经与肱骨骨性标志的关系 ,为肱骨手术或外固定提供帮助。方法　在 30例 6 0侧成人上肢标本上观、测了腋神经、桡神经与肱骨有关骨性标志的距离。结果　肱骨最大长 (30 6 6 5± 17 4 8)mm ;肱骨最近端到腋神经(5 8 10± 5 6 1)mm ;肱骨最近端到桡神经穿外侧肌间隔处 (177 75± 11 86 )mm ;解剖颈最低点到腋神经 (16 2 4± 2 78)mm ;肱骨最近端到肱骨肌管入口处 (118 4 9± 6 6 1)mm ;并测量计算了各段占肱骨最大长的比例。结论　腋神经在肱骨近端 1/ 5处容易受损 ,而桡神经在肱骨下 3/ 5段为易损伤部。从术前和术中的影像 ,能测量和计算出神经的基本位置 ,可减少或避免神经损伤

Applied anatomy of axillary nerve and radial nerve related to humerus

Objective To study the relationship of axillary nerve,radial nerve and bony landmarks of humerus and to provide help for operation of humerus.Methods The relative courses of axillary nerve,radial nerve and humerus were observed,and the longitudinal distances between the nerves and bone landmarks were measured on 60 sides of 30 adult cadaveric upper limbs.Results The biggest length of humerus was 306 65±17 84 mm;the distance from the proximal humerus to axillary nerve was 58 10±5 61 mm;the distance from the proximal humerus to lateral intermuscular septum was 177 75±11 86 mm;the distance from the lowest point of anatomical neck to axillary nerve was 16 24±2 78 mm;the distance from the proximal humerus to entrace of humeromuscular tunnel was 118 49±6 61 mm.The percentage of each distance to the biggest length of humerus were calculated.Conclusion The axillary nerve is easily injured in proximal 1/5 of humerus;whereas danger area to the radial nerve locatesat inferior 3/5 of humerus.Usingmeasurements calculated from preoperative and intraoperative imaging,the approximate position of the nerves could be determined,then nerve injuries could be reduced or avoided.