本研究的目的是加深对前臂近端神经分支模式的理解，并考虑最佳神经转移方案，以解决影响上肢功能的各种损伤。

解剖十一个上肢尸体标本，暴露前臂近端的桡神经、正中神经和尺神经。评估主要神经的神经分支的起源部位，并参考桡神经分支的外上髁和正中和尺神经分支的内上髁进行测量。使用相同的地标评估这些分支进入各自肌肉的位置（肌肉入口点）的距离。为了计划转移，神经分支的长度被计算为从主神经干的表观起源到神经进入肌肉的位置的差异。重要的是，神经分支起点被确定为与主神经干明显分离的位置，而无需与主神经干进行额外的束状解剖。确定分支的数量，并使用游标卡尺测量每个分支的直径。

桡神经分支至桡侧短伸肌 (ECRB) 的平均长度为 50.7 毫米，平均直径为 1.6 毫米。旋后肌桡侧分支的平均内侧和外侧长度分别为 22.2 毫米（直径 1.4 毫米）和 15.3 毫米（直径 1.3 毫米）。正中神经骨间前神经（AIN）分支位于内上髁远端 67.8 mm 处，直径为 2.3 mm。在大多数标本中，尺神经的尺侧腕屈肌 (FCU) 肌肉神经支配由 3 或 4 个分支提供。这些分支中的第二个和第三个最长，平均分别为 30.5 毫米（直径 1.4 毫米）和 30.7 毫米（直径 1.3 毫米）。

虽然样本之间前臂近端的神经分支模式存在差异，但作者提供了共性（分支模式和距离）的证据，可以促进上肢神经重建的规划。重要的是，所有测量值都是参考易于识别的骨标志及其肌肉入口点来提供的，以帮助做出手术决策。这些数据补充了上肢神经转移治疗各种病理的不断增长的实践。

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OBJECTIVE

The aim of this study was to add to the understanding of nerve branching patterns in the proximal forearm and consider optimal nerve transfer options to address the various injuries that affect the function of the upper extremity.

Eleven upper-extremity cadaveric specimens were dissected to expose the radial, median, and ulnar nerves in the proximal forearm. The site of origin of nerve branches from the major nerves was assessed, with measurements made in reference to the lateral epicondyle for the radial nerve branches and the medial epicondyle for the median and ulnar nerve branches. The distances to where these branches entered their respective muscles (muscle entry point) were assessed using the same landmarks. To plan a transfer, the length of the nerve branches was then calculated as the difference from the apparent origin from the main nerve trunk to the location where the nerve entered the muscle. Importantly, the nerve branch origin was established as the location of obvious separation from the main nerve trunk without additional fascicular dissection from the major nerve trunk. The number of branches was determined, and the diameter for each branch was measured using a Vernier caliper.

The radial nerve branch to the extensor carpi radialis brevis (ECRB) muscle had an average length of 50.7 mm and average diameter of 1.6 mm. The mean medial and lateral lengths of the radial branches to the supinator muscle were found to be 22.2 mm (diameter 1.4 mm) and 15.3 mm (diameter 1.3 mm), respectively. The anterior interosseous nerve (AIN) branch of the median nerve was found 67.8 mm distal to the medial epicondyle with a diameter of 2.3 mm. The flexor carpi ulnaris (FCU) muscle innervation from the ulnar nerve was provided by 3 or 4 branches in most specimens. The second and third of these branches were the longest, with means of 30.5 mm (diameter 1.4 mm) and 30.7 mm (diameter 1.3 mm), respectively.

While there is variability of the nerve branching pattern in the proximal forearm between specimens, the authors provide evidence of commonalities (branching patterns and distances) that can facilitate planning for upper-extremity nerve reconstructions. Importantly, all measurements are provided with reference to easily identified bony landmarks and to their muscle entry points to aid operative decision-making. These data complement the growing practice of nerve transfers in the upper extremity for a variety of pathologies.