正中神经返支的临床应用解剖

目的:研究正中神经返支的起始部位、体表投影及其相关数据,为腕管综合征手术治疗提供相关解剖资料。方法:常规解剖60侧经福尔马林固定后的成人手标本,肉眼观察正中神经返支的起点部位、行程和分布情况。测量正中神经返支的起点及止点坐标。以中指掌指横纹中点至腕远侧横纹中点的连线作纵坐标,以纵轴的中点作一与纵坐标相垂直的横坐标,将手掌分成四个象限,确定返支起始部位在象限中的体表投影。结果:正中神经返支的起点均在近侧桡侧象限,起点横纵坐标分别为6.73±1.84mm、26.20±5.57mm。结论:左、右侧正中神经返支的全长皆位于近侧桡侧象限内,因此设计腕管综合征的手术切口时,在中指掌指横纹中点至腕远侧横纹中点的连线尺侧切开皮肤或屈肌支持带,可避免损伤正中神经返支。

Clinical anatomic study on the recurrent branch of the median nerve

Objective:To study the starting and stopping position of the recurrent branch of the median nerve,its aspect table projection and associated data,to provide concerned dissecting datum for surgical operation of the carpal tunnel syndrome.Methods:60 sides hand specimen of dissected hands fixed in the formalin were applied,and then the starting point position,stroke and distribution circumstances of the recurrent branch of median nerve were observed with naked eyes,and coordinates of the starting and stopping point of the recurrent branchs of the median nerve were measuree.The line connecting the metcarpal cross striation of middle point and the middle point of the distal transverse line of the wrist was taken as the longitudinal axis.The line vertical the longitudinal axis at it's midpoint was taken as abscissa.As a result,the palm was divided into four quadrants,which can define the starting and stopeing point's table projection of the recurrent of median nerve.Results:The starting point of the recurrent of the median nerve is all in close to oar side quadrant,with the origin point coordinate(6.73±1.84mm,26.20±5.57mm).Conclusion:The recurrent of the median nerve is all in the close to oar side quadrant.Therefore when designing the skin incision of the carpal tunnel syndrome,we should cut skin or flexor retinaculum at ulnar side of the longitudinal axis,which can avoiding harming the recurrence of the median nerve.