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《Chinese Journal of Clinical Rehabilitation》 2006-24
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Distribution and localization of fascicular groups to intrinsic muscles of ulnar nerve trunk

Li Shao-guang1, Gu Li-qiang2, Shao Yan3, Sun Tian-sheng11Military Orthopeadics Center, General Hospital of Beijing Military Area Command of Chinese PLA, Beijing 100700, China; 2Department of Orthopedics and Trauma, First Affiliated Hospital, Sun Yat-sen University of Medical Sciences, Guangzhou 510080, Guangdong Province, China; 3Department of Orthopaedics, Shandong Chiping County Hospital, Chiping 252100, Shandong Province, China  
AIM: To observe the distribution of the fascicular groups in the ulnar nerve trunk on different cross-section stained by histological technique, in order to provide anatomical evidence for selective repair.METHODS: The experiment was performed at the Institute of Clinical Anatomy, Guangzhou First Military Medical University from December 2001 to April 2002. Totally 6 fresh cadaveric upper extremitiers were obtained from male adults, left and right (half and half). The mortal remains were donated from patients with brain death. The ulnar nerve and its branches were isolated. Specimens were got fromeach divided segment and marked direction by ink. After all specimens were cut into crossing sections by cryoultramicrotome, all slides were stained according to the AchE histochemical technique of Karnovsky-roots to distinguish motor nerve fibers and sensory nerve fibers. According to the staining combined with the microdissection result and the order of different branches branching off the nerve trunk, distribution of the fascicular groups to the intrinsic muscles were observed on each crossing sections. RESULTS: ①Staining feature of motor tract: Under high power lens it was shown that most fibers were moderate intensity positive reaction, enzyme staining limited at neuraxis, no staining at myelin sheath. Under low power lens only a few sparse block-shape enzyme staining regions were shown. ②Staining feature of sensory tract: Under high power lens enzyme reaction of resoluble myelinated fiber was negative, but in it there was a mass of strong positive block-shape enzyme staining region (nonmyelinated fiber region). Under low power lens the fibers showed confertim clumping shape and evenly distributed in nerve tract. ③Staining feature of mixed beam: It was thus evident the staining characteristics of above-mentioned two sources of nerve fiber enzyme. At the beginning the two kinds of fibers occupied their place, and then interlocked. But the two kinds of nerve fibers could be seen clearly based on their enzyme staining feature. At last the fibers mixed fully, dispersed in the tract. There was sparse block-shape enzyme staining region as compared with the sensory tract in the tract under low power lens. They could combined completely after one or two segments. ④Decision of distribution of functional fascicular group of each section: At the level of deep branch mixing into the trunk, the fascicular group of deep branch (to the intrinsic muscles) showed the staining character of motor tract, while the superficial branch showed the staining character of sensory fascicular on the cross-section. They were separated obviously. At the level of 6/16 forearm, the fascicular groups of deep and superficial branches mixed completely. From the level 13/16 to 16/6 of forearm, the sensory tract on the cross-sections consisted the group of dosal cutaneous branch. The mixed tract was the fasciculars group of deep and superficial branches. The motor tract was the tract to flexors of forearm. Its function could be determined based on their position. At the level of 15/16 of forearm, there was initial fibers-cross between the fascicular groups of dosal cutaneous branch and the mixed fascicular group. At the level of arm 1/8, fascicular groups of dorsal cutaneous branch, flexor carpi ulnaris (FCU) and the mixed fascicular group mixed completely. At the level of arm 3/8, the fascicular group of flexor digitorum profundus (FDP) mixed with the fascicular group of the mixed fascicular group that contained the fibers to the intrinsic muscles of hand. On the proximal level of arm 3/8, all the functional fascicular groups mixed completely.CONCLUSION: The localization and distribution range of the fascicular groups to the intrinsic muscles on each crossing sections can be known and outlined by using AchE histochemical staining combined with microanatomy results. Used in the operation, this method will contribute to judge the fascicular groups to the intrinsic muscles and ensure the accuracy of selective repairing.
【CateGory Index】: R322
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