【摘要】 目的 为腕管松解术及掌中间隙引流术提供解剖学基础。方法 在50例(男34例、女16例)福尔马林固定汉族成人尸体100侧手掌上对其血管、神经、腕横韧带及其位置关系进行了解剖学观测。结果 正中神经及其腕掌部分支均位于掌长肌腱尺侧与第三指蹼连线的桡侧，尺动脉位于尺神经桡侧，尺动脉终末支与正中神经干平行，间距为(11.2±2.3)mm。有尺/正中神经交通支者占94%，有掌浅弓者占78%；在掌长肌腱尺侧缘与环指中轴的连线上，腕远纹至交通支的距离为(35.5±3.5)mm，至掌浅弓的距离为(37.4±3.6)mm；腕横韧带下缘至交通支的距离为(6.5±3.2)mm，至掌浅弓的距离为(8.4±3.7)mm。结论 在掌长肌腱尺侧缘至环指中轴的连线上，腕远纹远侧35.5mm内以及37.4mm以下存在无血管、神经的相对手术安全区。

    【关键词】 手掌；掌浅弓；腕横韧带；尺/正中神经；交通支

    The study of the relationships between palmar neurovascular structures,the flexor retinaculum and the distal wrist crease

    LI Kai-rong,HU Guang-qiang,YANG Chao-xian,et al.

    Department of Anatomy,Luzhou Medical College,Luzhou 646000,China

    【Abstract】 Objective To provide the anatomical basis for the carpal tunnel and the middle palmar space drained.Methods Fifty adult cadaveric specimens(100 sides)fixed with formalin were dissected,analyzed and measured the palmar neurovascular structures,the flexor retinaculum and the distance between them and the distal wrist crease.Results The median nerve and its palmar branches lie to the radial side of the line from the third commissure the the ulnar aspect of the palmaris longus tendon.The ulnar artery situated the radial aspect of the ulnar nerve and is (11.2±2.3)mm from the median nerve.The ulnar/median communicating branch was observed in 94% of cases and the superficial palmar arch in 78%.The distance from the distal wrist crease to the communication branch had an average of (35.5±3.5)mm,to the superficial arch had an average of (37.4±3.6)mm in the axial line of the 4th metacarpal bone.At the same level,the distance between the retinaculum and the communicating branch was(6.5±3.2)mm,and the superficial arch was (8.4±3.7)mm.Conclusion On the line from the ulnar aspect of the palmaris longus tendon to axis of the ring finger,in the 35.5mm distance from the distal wrist crease,there is a security related area where is suitable approach to enter the carpal tunnel without injuring any important structures,and inferior to 37.4mm distance from the crease suitable approach to drain the middle palmar space. ......