The Research Of The Relevance Between The Anatomic Variation Of Supinator And Posterior Interosseous Nerve Enfrapment

Objective:Discuss the relevance between posterior interosseous nerve enfrapment and the anatomic variation of supinator and posterior interosseous nerve, providing a reference for clinical surgery to reduce the iatrogenic injury.Method:From 1986 to 2008, in the brisement surgery of posterior interosseous nerve enfrapment, we discovery 8 variations of supinator and posterior interosseous nerve. 7 males, 1 female; the yongest is 7 years old, the oldest is 67 years old; one combined fracture in superior segment of ulna, the others have no motivation. In the Exploration surgery of posterior interosseous nerve in Microscope, one with hourglass-like Change, non-nerve bundles through,we cut it and coincide; the others case of partial adhesion to the pressure,we decompress and release the outer membrane.We follow up all the patients, all recovery extension function of hand. From 1986 to 2008, we totally treat 336 patients with posterior interosseous nerve enfrapment, 243 males, 93 females; the yongest is 7 years old, the oldest is 67 years old.Operation method:Brachial plexus anesthesia, wrap tourniquet. From the inside edge of the brachial muscle to the radial-dorsal side of the top forearm, Vertical line down to about 10cm faraway the brachioradial Joint, we make a "S"-shaped incision. Then we cut the deep fascia in the gap between the short radial carpal extensor and the total extensor of fingers, and dissociate along the muscle clearance. Pull the short radial carpal extensor and the long radial carpal extensor to the radial, then expose the supinator and find the posterior interosseous nerve at the distal edge of supinator. Measure the distance from the radial head to the catchy of the supinator. We cut the Frohse arch and cut off part of the thickening outer membrane, then release the outer membrane of the posterior interosseous nerve. Release the tourniquet, and stanch bleeding, then wash the incision. At last, we place the released nerve into the good blood supply muscle gap, and suture the incision.Statistical methods of data:the location of the normal supinator: the distance from the radial head to the catchy of supinator is <30mm. Beyond the scope is formulated as the supinator variation.Result: Supinator variation: 8 cases.Conclusion:Posterior interosseous nerve enfrapment is related to the anatomic variation of supinator and posterior interosseous nerve. The low supinator has a wide range of activity, so it can be pressed easlily.