儿童肘部尺神经前置术的应用解剖

目的为临床儿童尺神经前置术提供解剖学基础。方法 10具(共20肘)福尔马林固定的6~8岁儿童尸体上肢标本,解剖尺神经沟、尺神经行径伴行血管以及尺神经前置后解剖关系。结果尺神经主要接受尺侧上副动脉血供,前臂尺神经的血供则主要由尺动脉提供,尺侧上副动脉、尺侧下副动脉及尺侧返动脉后支血管的大部分行程与尺神经紧贴伴行,在尺神经前置越过肱骨内上髁时,不会造成伴行血管过度牵拉而对尺神经血供造成影响。尺神经前置后滑动性好,有良好的组织床,同时又能解除屈肘对尺神经牵拉。结论研究结果显示:尺神经前置术不会影响神经血供,具有可行性,前置时需切断上臂内侧肌间隔,皮下前置滑动性好。

Applied anatomy of the anterior transposition of ulnar nerve in children elbow

Objective　 To provide anatomical basis for the treatment of humeral supracondylar fracture of children with the anterior transposition of ulnar nerve.　Methods　20 elbow specimens from 10 children cadaveric upper limbs (aged from 6 to 8) were used in this study. Anatomic features of ulnar nerve and its accompanying vessels, and ulnar groove were explored, while, anatomic position of the nerve after anterior transposition were analyzed.　Results　Ulnar nerve was supplied mainly by superior ulnar collteral artery, however, this nerve was nourished mainly by ulnar artery when it passed through the foream. Ulnar nerve was always accompanied by superior and inferior ulnar collteral arteries, and the posterior branch of ulnar recurrent artery during its course, which would not be interfered during the approach of anterior transposition of ulnar nerve. Transferred ulnar nerve located on the soft tissue bed, easy to be slided, and escaped from the drag injury caused by flexion movement of elbow joint.　Conclusions　Anterior transpostion of the ulnar nerve is favorable for blood supply of the nerve, and the slide movement.