| Objective:Peripheral nerve defect caused by tumor excision and trauma is a common clinical problem that often leads to more or less degree of disability or even disability completely. Repairing of neural defects and its founctional recovery is always an intractable problem and popular issue in the peripheral nerve regeneration field. The most primitive and effective method to solve the problem is self-neural transplantation. Self-neural transplantation, at the expense of autogeneic tegumentary nerve, results in functional damage of donor nerves. Therefore many scholars devote themselves to investigate other ways to take place of self-neural transplantation, such as allogenic, xenogeneic, artificial neural transplantation and nerves tube-shield bridging (including vein, skeletal muscle, silicon tube, PGA tube) and so on. But the outcomes of above methods are worse than self- neural transplantation in clinic. Self-neural transplantation nourished by blood vessels is the only practical and reliable method in treating long distance neurologic defect. In early 1990s, Viterbo raised the method of end-to-side neurorrhaphy to solve long distance neurologic defect basing on the fact above. Through the end-to-side neurorrhaphy between damaged nerves (recipient nerves) and normal nerves (donor nerves), the donor nerves sprouting collaterally to the recipient nerves which make the function of target organs recovered to some degree. Because the function of the donor nerves is not affected, scholars have had great interest in it. Although a lot of experimental and clinical researches have verified the phenomenon of nerve sprouting collaterally, but the effect of end-to-side neurorrhaphy is worse than that of end-to-end neurorrhaphy was also witnessed. In this study we investigated the superficial radial nerve and its bordered structures anatomically, in order to provide anatomic basis for clinic using of superficial radial nerve transplantation and reconstructing the function of the donor site.Methods:We have investigated 30 adult cadaveric upper limbs (left 15 and right 15) that fixed by Formaldehyde. Longitudinal skin cut was made from condylus lateralis humeri to malleolus radialis. The superficial radial nerve and cephalic vein was exposed, with the proximal end to the starting point of the superficial radial nerve and the distal end to metacarpal bone of dorsum manus. First the distribution and relationship of the superficial radial nerve and cephalic vein was observed, then four points of A, B, C, D was made by pins as marks. A is the point of the most outstanding of condylus lateralis humeri. B is the point of malleolus radialis. C is start of the superficial radial nerve. D is bifurcation of the superficial radial nerve. Then use the sliding caliper (accuracy rating 0.02mm) measured the data following: the length of the superficial radial nerve (CD), length from start and bifurcation of the superficial radial nerve to point of malleolus radialis(CB, DB), the length of deep the superficial radial nerve, the perpendicular distance from C to AB, the traversal diameter of radial nerve at different sites and the perpendicular distance from D to cutaneous antebrachii lateralis nerve and. median nerve. Three fresh cadaveric upper limbs were selected to perform HE staining to count nerve-tract numbers of the same horizontal of cutaneous antebrachii lateralis nerve and median nerve under a microscope. 8 cephalic vein of fresh cadaveric upper limbs were perfused with polyvinyl chloride cyclohexanone solution, then the relation of little branches of cephalic vein and superficial radial nerve was observed. Red emulsion was perfused to arteries of 8 upper limb specimen, then the length and blood supply of median nerve were observed.Results:Radial nerve divides to superficial branch and deep branch at 1cm radial to of cubital fossa biceps tendon and the anterior aspect of condylus lateralis humeri. Ramus superficial is divides of radial nerve to the superficial section and deep section in forearm, it steps over supinator muscle, round pronator muscle, perforans manus and musculus flexor hallucis longus by turns, This section is covered by supinator longus, so called deep section whose length is 124.89+10.52mm. At the juncture of forearm middle and down 1/3 one third from distal to proximal forearm, ramus superficialis nervi radial is start out between supinator longus and long radial extensor carpal muscle, pricking deep fascia under the skin. Before dividing to interior internal and external branch it is called superficial section (CD)whose length is 31.87+12.54mm.The distance from starting point and bifurcation to iacemic modification malleolus radial is(CB,DB)is 89.90+10.54mm and 59.26+14.23mm.The vertical dimension from the starting point to AB line is 3.80+2.50mm. The vertical dimension from bifurcation of ramus superficialis nervi radial is to lateral antebrachial cutaneous nerve is 5.99+1.50mm. and the vertical dimension to the median nerve is 35.66+2.82 mm. The diameters transversa of initiation point of the superficial radial nerve is 2.68+0.46mm, the superficial point is 3.17+0.51mm, the branch point is 2.53+0.42mm.The diameters transversa of cutaneous antebrachii lateralis nerve in different region is 1.03+0.08mm and 0.97+0.07mm. The diameters transversa of intercondylar line of median nerve is 5.31+0.06mm, the region of upper 10cm of malleolus radialis is 4.86+0.06mm, malleolus radialis is 4.46+0.05mm. The diameters transversa of ulnar nerve of groove of ulnar nerve is 4.85+0.06mm, the region of upper 10cm of malleolus ulnaris is 2.77+0.05mm, the radial of lentiform bone is 3.43+0.04mm.Conclusion:1 The superficial radial nerve is superficial, immobility consistent, less branches and easy to draw the materials from. So it can supply the favourable donator nerves for curing neurologic defect. Even when the neurologic defect is relative small especially that of upper limbs,to use superficial radial nerve is more convenient and simpler either on anaesthesia and or on operative procedure.2 When both nervers and vessels are defective and the defective length of them is less than 70mm, especially the defect of upper limbs,we can use superficial radial nerve with cephalic vein to repair .3 After cutting superficial radial nerve,we can reconstruct sensory function of the donor by way of end-to-side anastomosis between far broken ends of superficial radial nerve and median nerve or and lateral antebrachial cutaneous nerve.4 The function of extending wrist is not affected after cutting superficial radial nerve.
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