正中神经与尺神经吻合的解剖学研究及法医学鉴定意义

目的探讨中国人群正中神经-尺神经吻合(Martin-Gruber anasmotosis,MGA)情况及其对尺神经损伤法医学鉴定的影响。方法通过105例中国人上肢正中神经、尺神经解剖,观察MGA变异情况,对MGA的分型、走行及位置等进行分析,了解该变异对尺神经损伤法医学鉴定的影响。结果105例中发现24例MGA,MGA出现率为22.9%,男性出现率略高于女性,单双侧及左右侧无明显个体差异。24例MGA中,I型>Ⅱ型>Ⅳ型>Ⅲ型(分别占45.8%,25%,16.7%和12.5%)。正中神经起始点位于内外髁连线上4.11cm至连线下9.95cm,平均前臂连线下3.05cm;尺神经止点位置均在连线3cm以远,最远至连线下14.7cm,平均连线下8.05cm。结论中国人群存在MGA的位置多见于尺神经损伤的常见部位,对尺神经损伤的法医学鉴定有一定的影响。

Anatomy study of MGA in Chinese and its effect on legal expertise

Objective This study aimed to clarify the morphology of the Martin-Gruber anastomosis(MGA) in Chinese.Methods One hundred and five Chinese upper limbs(36 males and 20 femalese) were dissected to find the connections between medial nerve and ulnar nerve.The MGA was classified as previously described by Lee.Results MGA was found in 24 cases(22.9%),in 11 of the 36 male and 5 of the 20 female.There was no obvious difference in the frequency of MGA in both upper limbs.Most MGA ulnar position was located at the medial and distal segment of the forearm.Conclusion MGA anatomy could play important role in forensic diagnosis of ulnar nerve injury in Chinese population.