腕关节神经支配的解剖学研究

目的观察支配腕关节神经的来源、直径、数目及其行径；为去神经支配治疗腕关节疼痛提供解剖学资料。方法对10具20侧福马林固定的上肢标本，在手术显微镜下解剖并观察骨间后神经、前臂外侧皮神经、桡神经浅支、尺神经腕背支支配腕关节背侧的腕关节支；骨间前神经、正中神经掌皮支、尺神经深支及其主干支配腕关节掌侧的关节支。结果骨间后神经是支配腕关节背侧神经的主要来源；前臂外侧皮神经、桡神经浅支、尺神经腕背支也发支支配腕关节背侧。骨间前神经、正中神经掌皮支、尺神经深支发支参与支配腕关节的掌侧。结论用去神经支配的方法治疗腕关节顽固性疼痛主要适用于腕背侧的疼痛。

Anatomical study of wrist joint innervation

Objective To study origins, diameters, amounts and pathways of nerves innervating wrist joint and provide anatomical evidence for treating wrist pain at dorsal surface by denervation. Methods 20 sides in 10 cases of upper extremity cadavers fixed by formalin were involved .Microscopic anatomy dissected posterior interosseal nerve, forearm lateral cutaneous nerve, superficial branch of radial nerve, wrist joint branch of wrist dorsal branch of ulnar nerve innervating wrist in the dorsal surface as well as anterior interosseal nerve, palmar cutaneous branch of median nerve, profound branch of ulnar nerve and its main trunk of wrist branch innervating wrist joint in palmar side . Results Wrist joint at dorsal part was principally innervated by posterior interosseal nerve .It was also innervated by forearm lateral cutaneous nerve, superficial branch of radial nerve, wrist dorsal branch of ulnar nerve. Wrist joint at palmar side was innervated by anterior interosseal nerve, palmar cutaneous branch of median nerve and profound branch of ulnar nerve.Conclusion Treatment of intractable pain of wrist joint by denervation is mainly indicated in wrist pain at dorsal side.