| Objective:Looking for a new method of preventing nerve injury discover a safe surgical path and guide orthopedic surgery by anatomical study of posterior interosseous nerve(PIN).Further enhance surgical safety.Materials and methods:1.20 cases of upper limb adult specimens fixed with formalin.right 10 cases.left 10 cases.8 cases of adulthood fresh upper limb specimens.right 4 cases.left 4 cases.2·Anti-corrosion specimens general anatomied.revealed Supinator and PIN. Observed running and position of PIN.measure L1 (distance from nerve issuing points to radial head). L2 (distance from nerve issuing point to the enter supinator point).L3(distance from point piercing supinator to radial head).L4 (distance from radial styloid to radial head).L5(horizontal distance from nerve piercing the supinator point to the line between the HLE and radius Lister tubercle), L6 (distance from nerve piercing the site of supinator to ulna inner fringe).L7 (distance from intersection point of nerve and outboard radius neck center line to radius head).R (the angle between line of the supinator entry and exit points and line of humerus outside mounts a condyle and radius belemnoid.3. Forearm are placed g forward rotating position. three-point of Humerus lateral epicondyle(A). Styloid process(D).Lister tubercle(E) joint a triangle. Joint point A ang DE midpoint F. observe relationship between muscle branches of PIN. ADE triangle and AF line.4. Exposure the muscle branches of PIN. Carefully separated muscle branches and enter points of muscle.Reveal and observe traveling and distribution.measure the distance from starting point and enter points of muscle to fixed point. Results:1. Digital of PIN Uuits:mm (x±s, nL=14, nR=14) L1 left 14.74±0.24, right 15.82±0.56; L2 left 31.76±0.32, right 30.52±0.48; L3 left 65.70±0.92, right 63.26±0.31; L4 left230.26±0.23, right 232.34±0.54; L5left6.22±0.34, right 6.86±0.26; L6 left 25.34±0.53, right 24.82±0.67; L7 left 42.74±0.62, right 43.58±0.28; R left 30.00±0.20, right 32.00±0.10。2. The angle between line of the supinator entry and exit points and line of humerus outside mounts a condyle and radius belemnoid RL30.00±0.20±, RR32.0±0.10±(x±s, nL=14, nR=14)。3. The distance from starting point and enter points of muscle to fixed point and quantity of the branches Uuits:mm (x±s, n=28) BB39.44±0.15,11.78±0.32,1.9±0.2; ECRLB 35.52±0.16,10.94±0.36,1.8±0.1; ECRBB 45.92±0.32,66.92±0.12,2.6±0.1; SB 61.94±0.57,67.92±0.14,1.6±0.3; EDB 69.82±0.36, 93.98±0.02,4.9±0.2; ECUB 76.92±0.58,92.94±0.37,2.9±0.4; EDMB 78.82±0.48, 95.76±0.12,1.3±0.2; APLB 96.74±0.18,125.92±0.36, 1.1±0.1; EPBB 103.22±0.52, 144.52±0.12,1.5±0.3; EPLB 102.92±0.64,130.36±0.82,1.0±0.1; EIB 130.98±0.74, 148.46±0.48,1.0±0.2; EMB 101.38±0.58,10.18±0.78,1.1±0.2.4. PIN trunk above AD line account for 78.6%. AD line radial side account for 10.7%. AD line ulnar side side account for 10.7%.Conclusion:1. Combined with regionial location and line location is more accurate positioning method about posterior interosseous nerve.2. Point of posterior interosseous nerve piercing supinator is looked as a important positioning mark.Postgraduate:Shi-fang Li (Department of anatomy)Directed by:Yu-yanXiang... |
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