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目的:了解有关应用骨间前神经旋前方肌支转位修复正中神经鱼际肌支和尺神经深支的解剖,总结应用此方法的临床效果。方法:观察6具成人上肢标本,测量其旋前方肌支、正中神经鱼际肌支和尺神经深支的横径,以及正中神经鱼际肌支起始处、尺神经深支起始处至旋前方肌上缘的距离。1996年4月～1997年3月,临床应用5例。旋前方肌支转位修复陈旧性尺神经损伤3例,陈旧性正中神经损伤1例,急性正中神经损伤1例,其中3例需游离神经移植。结果:骨间前神经旋前方肌支在旋前方肌上缘处、正中神经鱼际肌支起始处、尺神经深支起始处,神经干横径分别为1.3～1.9、1.5～2.3、1.8～2.3 mm。正中神经鱼际肌支起始处、尺神经深支起始处至旋前方肌上缘的距离分别是75.2～84.8 mm、53.5～74.0 mm。临床应用经12～23个月随访,4例手内在肌功能恢复M3～M4级,1例未见恢复。结论:骨间前神经旋前方肌支转位修复正中神经鱼际肌支和尺神经深支可达到肌支-肌支修复的设想,缩短再生距离和时间,有利于手内在肌的功能恢复。
OBJECTIVE: To understand the anatomy of the anterior interosseous medullary branch and the ulnar nerve branch of the anterior interosseous nerve pronation muscle transposition for the purpose of summarizing the clinical effect of this method. Methods: Six adult upper extremities were observed and their transverse diameters of the anterior branch of the pronator, the intermuscular branch of the median nerve and the deep branch of the ulnar nerve were measured, and the origin of the medullary branch of the median nerve at the beginning of the deep branch of the ulnar nerve Pronation on the edge of the upper edge of the distance. April 1996 ~ March 1997, 5 cases of clinical application. Anterior rotation of the musculocutaneous branch in the repair of old ulnar nerve injury in 3 cases, old median nerve injury in 1 case, acute median nerve injury in 1 case, of which 3 cases required free nerve transplantation. Results: The anterior branch of anterior pronator of the anterior interosseous artery was located at the upper edge of the anterior pronator, the beginning of the interosseous branch of the median nerve, the beginning of the deep branch of the ulnar nerve and the transverse diameter of the trunk were 1.3-1.9, 1.5-2.3, 1.8 ~ 2.3 mm. The distance between the medial branch of the median nerve and the superior margin of the ulnar nerve was 75.2-84.8 mm and 53.5-74.0 mm, respectively. Clinical application of 12 to 23 months follow-up, 4 cases of hand muscle function recovery M3 ~ M4 grade, 1 case no recovery. CONCLUSION: Anterior rotation of anterior interosseous nerve branch can repair the branch of the medial branch of the median nerve and the deep branch of the ulnar nerve. It can shorten the regeneration distance and time, which is beneficial to the functional recovery of the hand internal muscle.