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Objective To reconstruct on the basis of histological study the computerized 3D ima ges of the fascicular groups of ulnar nerve,which can be used to guide the microsurg ical repair of injuries of brachial plexus and ulnar nerve and to provide morpholog ical evidence for the functional rec overy of intrinsic muscles of hand after root avulsion of brachial plexus.Methods The successive AchE-staining histo logical cross-sections were made.T he photos of the sections were transformed into digital information and sto red in the computer.Different functional fas-cicular groups were distinguished a nd marked on each section.The topographic database was analyzed by image pro-cessing software,with the support o f OpenGL three dimensional graphic l ibrary.3D images of the fascicular g roups of ulnar nerve were reconstructed usin g the contour-based surface constru ction method in the program written w ith VC language.Results The 3D images of the individual external surface of the reconstructive fa scicular groups were displayed and the human-computer in teraction was realized by performin g the arbitrary rotation and the rand om cross-section.By selecting the int erested object,the spatial structu re of any fascicular group could be di splayed in the same space simultaneously.Compare d with the result of microanatomy,th e 3D shape could truly reflect the str ucture,adjacent relationship and arrangem ent of fascicular groups in the ulnar nerve trunk.Conclusions Since the re-constructive 3D images can truly reflect the arrangement and distribution of the functional fascicular grou ps,they will have positive effects on understanding the internal structure of ulnar nerve,designing operative procedur e and adjusting operative method for surgeons.[
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Objective To observe the arrangement and distribution of the fascicular groups in the ulnar nerve trunk to the intrinsic muscles so as to provide anatomical evidence for selective repair in the clinic.Methods 12 cadaveric upper extremities recently embalmed with formalin were obtained. The ulnar nerve and its branches were exposed. Microanatomy and longitudinal contradissection of each functional fascicular group were performed by tracing their terminal branches, and the arrangement and distribution were observed and recorded. The fascicular groups to the intrinsic muscles of hand in the nerve trunk were observed to see how they crossed and mixed with other fascicular groups. The diameter of the nerve trunk and the fascicles to the intrinsic muscles were measured, and the area and the distribution range of the fascicles calculated. Results The shape and the diameter of the ulnar nerve trunk varied at different positions. The fibers of functional fascicular groups had the definite differentiation at distal while interfused and diffused at proximal. The fascicular groups to the intrinsic muscles of hand were the largest and their fibers relatively concentrated (the distribution range occupied 40% ～ 80% of the ulnar nerve), and had the definite localization at the forearm and distal to the 3/8 segment of upper arm. Conclusion Since the fascicles to the intrinsic muscles of the hand are the most important in the ulnar nerve, selective repair by using epineural and perineural techniques at the forearm and upper arm will reduce the loss of nerve fibers and will contribute to the functional recovery.
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Objective To observe and study the distribution and histological feature of the fascicular groups to deltoid muscle in axillary nerve at the level of quadrilateral zone. Methods 12 adult human cadavers (24 upper limbs)embalmed by formalin were used,, and microsurgical longitudinal contradissection of the axillary nerves by tracing their terminal branches were processed. At the level of quadrilateral zone,distrabution of the fscicular groups to deltoid muscle in the never trunk were recorded and their diameters were measured;Another 6 upper extremities (3 right and 3 left) of fresh-frozen human cadavers were obtained.Axillary nerves and their fascicular groups were exposured, and the segments at the level of qusdrilateral zone gotten, then histological cross section was done, acetycholinesterase (ACHE) stained with the method of Karnovsky Roots and myelin stained with the method of Loyezs. Defferent never fibres were distinguished under microscope and the fiber number was counted with IAS . Results At the level of quadrilateral zone,fasciculars were divided into two groups.The fascicular group of anterior branch to deltoid muscle was in the lateral of the nerve trunk . Its cross sectional area was (2.449?1.327)mm2 ,occupied 55.4%?9.3%of the axillary nerve trunk ;Its most fibers were motor fibers;The number of fibers is (2112?631), occupied 45.6 %?1.1%of all fibers of axillary nerve . Conclusions In the treatment of root avulsion of brachial plexus injury, selective suture donor nerve with the lateral fascicular group should be processed to repair the function of shoulder abduction,fibers loss would be reduced and rate of functional restoration improved .