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目的对胸背神经的外侧束和腋神经穿越四边孔后支配的三角肌肌支进行显微解剖研究，并应用于临床，为臂丛神经损伤后功能重建提供新的方法。方法取 17具成人尸体，在手术显微镜下对 31侧胸背神经外侧束和腋神经三角肌肌支进行解剖，观察其可应用长度、直径及分支情况，并取神经标本经 HE染色、石蜡切片，对有髓神经纤维进行计数。临床上进行 3例手术。例 1将胸背神经外侧束与四边孔内切断的腋神经三角肌肌支吻合。例 2在例 1术式基础上，用胸背神经内侧束支配的部分背阔肌重建屈肘功能。例 3将背阔肌按内、外侧束的支配区域，剪切成两部分，移位的同时重建屈肘、屈指功能。结果胸背神经在入背阔肌处开始分为内、外侧束，外侧束明显较内侧束粗大。外侧束在背阔肌内可利用的长度平均为 58.2 mm，直径平均为 1.46 mm，有髓纤维数平均为 1 519根， 90.4％的外侧束可再分为 2支或 3支。腋神经三角肌肌支直径平均为 2.31 mm，有髓纤维数平均为 2 341根， 61.3％的三角肌肌支可再分为 3支， 32.3％的三角肌肌支可再分为 2支。 3例术后情况 :例 1三角肌肌力为 4级；例 2三角肌肌力为 4级，屈肘时肌力为 4级；例 3屈肘、屈指时肌力均达到 4级。结论应用胸背神经双分支的解剖基础，将胸背神经外侧束与腋神经三角肌?
OBJECTIVE: To dissect the deltoid musculoskeletal branches of the thoracic dorsal nerve and the deltoid muscle branches of the axillary nerve crossing the quadrilateral limbs, and to apply them to clinic. It provides a new method for functional reconstruction after brachial plexus injury. Methods Seventeen adult cadavers were used to dissect the lateral bundle of the lateral thoracodorsal nerve and the deltoid muscle of the axillary nerve under a surgical microscope. The length, diameter and branch of the deltoid muscles were observed. The nerve specimens were harvested and stained with HE and paraffin sections , Myelinated nerve fibers were counted. Clinically 3 cases of surgery. Example 1 The lateral thoracodorsal fascia and amputation of the quadrilateral hole in the axillary nerve deltoid muscle anastomosis. Example 2 Based on the procedure of Example 1, the elbow flexion function was reconstructed with part of the latissimus dorsi muscle dominated by the medial bundle of the thoracodorsal nerve. Example 3 The latissimus dorsi muscle by medial and lateral bundle of dominating area, cut into two parts, while displacing the elbow flexion, flexor finger function. Results Thoracodorsal nerve began to be divided into latissimus dorsi and medial lateral bundle, lateral bundle significantly larger than the medial bundle. The average lateral bundle length available in the latissimus dorsi muscle was 58.2 mm, with an average diameter of 1.46 mm. The average number of medullated fibers was 1 519. The lateral bundle of 90.4% could be subdivided into 2 or 3 branches. The mean diameter of the axillary muscle of the axillary nerve was 2.31 mm, the average number of myelinated fibers was 2 341, the deltoid muscle branch of 61.3% could be subdivided into 3 branches, and the deltoid muscle branch of 32.3% could be subdivided into 2 branches. 3 cases of postoperative situation: 1 deltoid muscle strength of 4 cases; 2 deltoid muscle strength of 4, elbow muscle strength of 4; 3 elbow flexion, flexion when muscle strength reached 4. Conclusions Application of anatomical basis of the bifidus and dorsal branch of the thoracodorsal nerve and the axillary nerve deltoid?