臂部正中神经内神经束组分布的解剖学研究及其临床意义

目的 为在修复臂段正中神经中的重要束组及利用臂段部分神经作束组移位提供解剖学依据。方法 对34侧成人上肢标本的臂部正中神经内神经束组的分布作了显微外科观察。结果 在臂中、下段，正中神经的分支恒定地组成3个神经束组：旋前圆肌肌支和桡侧腕屈肌肌支束组在神经干的前方，骨间前神经和掌长肌肌支束组在神经干的后方，中间束组是由指浅屈肌肌支和手部分支组成的正中神经前臂主干的近段。结论 骨间前神经和掌长肌肌支、旋前圆肌肌支和桡侧腕屈肌肌支可在臂中、下段从正中神经干分离出来进行修复和移位。在臂部采用正中神经部分移位时，要了解神经干内束组的分布特点。

The topographic features of the fascicular groups of the median nerve in the upper arm and its clinical significance

Objective To provide anatomical data for repair of important branches of the median nerve and for nerve transfer using part of the median nerve in the upper arm. Methods 34 upper limbs of human cadavers were used. Microanatomical dissection of the median nerve was done to observe the distribution of fascicular groups of the median nerve in the upper arm. Results In the distal two - thirds of the upper arm, branches of the median nerve constantly formed three fascicular groups. The anterior part of nerve trunk hosted branches to the pronator teres (PT) and the flexor carpi radialis (FCR). The posterior part of nerve trunk contained the anterior interosseous nerve (AIN) and branches to the palmaris longus muscle (PL). Branches to the hand and to the flexor digitorum superficialis (FDS) which was the main trunk of the median nerve at the proximal forearm were grouped to form the middle part. Conclusions The fascicular group to PT, FCR, PL and AIN can be separated from median nerve in the distal two - thirds of the upper arm, and thereby be selectively repaired and transfered. The distribution of intraneural fascicular groups should be concerned when partial transfer of median nerve in the upper arm was done.