Anatomical study of the anterior neurovascular interval approach of the elbow

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  Objective: Authors study the anatomy of anterior nerve and artery of the elbow joint to provide the reference about the relevant surgical approach of the elbow joint,can find the simple better surgical approach on treatment of part of fractures of elbow joint.Methods: The upper extremities of 10 adult cadavers that were fixed by formaldehyde and affused latex from artery,were observed anatomic structure of the anterior approach of elbow joint.From the clearance of the brachioradialis and pronator Teres muscle into the approach of neurovascular interval,We observe states of the median nerve and the brachial artery,radial artery and ulnar artery and their branches through anatomical layers and measurement methods.The front capsule of elbow joint,the coronoid fossa of the humerus,the trochlea of humerus,the 0humeroulnar joint and the coronoid process were exposed through the surgical approach,and the radial branches of the brachial and radial artery and their diameter in themselves and the ulnar branches of the brachial and ulnar artery were observed and measured,the distance between these branches and the fork of radial and ulnar artery were measured,the median and its branches anatomical characteristics and the distance of no intersecting branches between nerve and artery were observed and measured.Results: Through anterior neurovascular interval approach of elbow,nerve and artery can be protected,the ulna coronoid process,humeroulnar joint,trochlea of humerus,the anterior structures of the elbow.Without intersecting branches between median nerve and brachial artery and its average length was 6.04cm,the interval between median nerve and brachial artery was loose and easy to separate to the two sides,the corresponding part of elbow clearly exposed the space of the special structure.The medial branch of brachial,ulnar artery was less,thinner than the lateral branch of brachial,radial artery,so the artery traction laterally was easy.The branches of median nerve were basically from the medial of nerve and extended medially,the angle between the branch and the main trunk was very small,they were almost parallel,so the best surgical field can be exposed through the medial retraction of median nerve.Conclusion: The study demonstrates that the anterior anatomical structure of the elbow joint,including the trochlea of the humerus,coronoid process of the ulna and the front capsule of the elbow can be exposed through the anterior neurovascular approach of elbow.There were simple,safe advantages,it was easier to expose,less soft tissue dissection,fewer complications,convenient to operation,shorter time to recover,a better surgical approach of elbow.
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