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目的对肘部供应神经、尺神经分支、尺侧上副动脉灌注尺神经的长度、肘部前内侧深筋膜血供等情况进行解剖学分析。方法对10具正常成人新鲜尸体进行解剖,观察肘部神经分支、血液供应。通过对新鲜尸体进行模拟尺神经的手术操作过程,主要是采用尺神经松解前置的方法,将尺神经进行充分的手术,游离尸体肘部后侧神经,同时观察肘部神经供养血管,最后再进行前置,这样就能够合理地测量出尺神经能够达到的最大前置距离。深筋膜动脉采用肘动脉灌注墨汁,同时将尺神经组织切片的方法观察足侧上副动脉对尺神经内部血供营养的长度。结果尺神经的营养血供、腋部内侧肌间隔后方、尺神经沟、前臂部。通过手术测试发现动脉和神经的伴行距离分别是15.0 cm、5.0cm和5.5 cm,神经的起点距离肱骨内上髁的距离,通过测试分别是15.5 cm、6.0 cm和5.5 cm。通过对新鲜的尸体进行手术后,游离的神经可以和尺神经一起跨过内侧的上上髁向桡侧方向,前置的距离最少也可以达到7 cm。结论行尺神经深筋膜瓣下手术,至少应该保留尺侧上或是尺侧下的副动脉,从而达到手术的目的。应依据任意皮瓣原则进行深筋膜瓣的制作。
Objective To analyze the anatomy of the elbow supply nerve, ulnar nerve branch, ulnar artery perfusion ulnar nerve length, elbow anteromedial deep fascia blood supply and so on. Methods Ten fresh corpses of normal adults were dissected and the nerve branches and blood supply of the elbow were observed. Through the simulation of fresh corpse ulnar nerve operation process, the main method is to use the ulnar nerve to release the front of the ulnar nerve full operation, free body back elbow nerve, while watching the elbow nerves to support blood vessels, and finally And then the front, so that we can reasonably measure the ulnar nerve can reach the maximum lead distance. The deep fascia artery was infused with elbow artery ink, while the ulnar nerve tissue section method to observe the foot side of the accessory arteries on the ulnar nerve blood supply and nutrition of the length. The results of ulnar nerve nutrition blood supply, the medial axilla medial septum rear, ulnar nerve groove, forearm. The surgical distance between the artery and the nerve was 15.0 cm, 5.0 cm and 5.5 cm, respectively. The distance from the origin of the nerve to the medial epicondyle of the humerus was 15.5 cm, 6.0 cm and 5.5 cm, respectively. After surgery on fresh corpses, the free nerve can extend across the medial superior epicondyloid along the ulnar nerve in a radial direction with a minimum forward distance of up to 7 cm. Conclusions The operation of deep fascia and subfascial ulnar nerve should at least keep the accessory arteries on the ulnar or ulnar side to achieve the purpose of surgery. Should be based on the principle of any flap deep fascia flap production.