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目的探讨桡骨头颈部手术的安全区,为骨间后神经卡压综合征的手术治疗提供解剖学资料。方法在80侧上肢标本上解剖观测骨间后神经桡管段的行程、毗邻和可能存在的卡压部位。结果在桡管内,骨间后神经在桡骨头前方附近自桡神经发出,隔肘关节囊、环状韧带越过肱骨小头、桡骨头行至桡骨颈外侧中线处与桡骨颈交叉。该交叉部位距桡骨头上缘(3.6±0.4)cm;桡侧返血管的分支、桡侧腕短伸肌腱弓均对骨间后神经形成卡压。结论桡骨上端后外侧3.0 cm范围内是桡骨头颈骨折手术暴露、放置钢板的安全区;在行骨间后神经减压术,切开Frohse腱弓的同时,将桡侧返血管的分支和桡侧腕短伸肌腱弓一并处理。
Objective To explore the safety zone of radial head and neck surgery to provide anatomic data for surgical treatment of posterior interosseous nerve compression syndrome. Methods Eighty lateral upper extremity specimens were dissected to observe the course of the interosseous radial nerve segment, adjacent and possible compression sites. Results In the radial tube, the posterior interosseous nerve was radiated from the radial nerve near the front of the radial head. The elbow joint capsule and the annular ligament passed over the small humeral head. The radial head was crossed to the radial neck at the midline of the radial neck. The cross from the upper edge of the radial head (3.6 ± 0.4) cm; radial vascular branch, radial wrist extensor tendon arch compression of the posterior interosseous nerve. Conclusions Within 3.0 cm of the posterior radius of the radius, the radial head and neck fracture is exposed and the safe zone of the plate is placed. In the interosseous posterior nerve decompression, the Frohse tendon arch is incised and the branch and radial side of the radial artery Wrist short extensor tendon bow together.