Kadaverska studija anatomskih varijacija žbičnog živca i njihov klinički značaj

  • Milan Aksić University of Belgrade, Faculty of Medicine, Institute of Anatomy “Niko Miljanić”, Belgrade, Serbia
  • Katarina Djurdjević University of Belgrade, Faculty of Medicine, Institute of Anatomy “Niko Miljanić”, Belgrade, Serbia
  • Slobodan Kapor University of Belgrade, Faculty of Medicine, Institute of Anatomy “Niko Miljanić”, Belgrade, Serbia
  • Laslo Puškaš University of Belgrade, Faculty of Medicine, Institute of Anatomy “Niko Miljanić”, Belgrade, Serbia
  • Dražan Erić Al Emadi Hospital, Department of Plastic and Reconstructive Surgery, Doha, Qatar
  • Lazar Stijak University of Belgrade, Faculty of Medicine, Institute of Anatomy “Niko Miljanić”, Belgrade, Serbia
  • Dubravka Aleksić University of Belgrade, Faculty of Medicine, Institute of Anatomy “Niko Miljanić”, Belgrade, Serbia
  • Dejan Aleksandrić Institute of Orthopedic Surgery “Banjica”, Belgrade, Serbia
  • Miloš Mališ University of Belgrade, Faculty of Medicine, Institute of Anatomy “Niko Miljanić”, Belgrade, Serbia
  • Vuk Djulejić University of Belgrade, Faculty of Medicine, Institute of Anatomy “Niko Miljanić”, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP230714052A
Ključne reči: anatomija, regionalna, anatomija,varijacije, kadaver, n. radialis, pol, karakteristike

Sažetak


Uvod/Cilj. Žbični živac (nervus radialis – NR) je najveća završna grana zadnjeg snopa ramenog živčanog spleta. Nakon što napusti pazušnu jamu, taj živac prelazi u zadnji region nadlaktice, gde stupa u bliski odnos sa ramenom kosti. Prolaskom kroz spoljašnju međumišićnu pregradu, NR ulazi u prednju ložu nadlaktice, da bi se na kraju, u predelu spoljašnjeg čvora ramene kosti, podelio na svoje dve završne grane. Anatomiju ovog živca odlikuje izuzetna varijabilnost, čije je poznavanje od velikog značaja u oblasti ortopedske i traumatske hirurgije. Cilj rada bio je da se ispita anatomija NR uključujući dva parametra: mesto i način podele NR na završne grane, sa posebnim naglaskom na kliničkom značaju ovih podataka. Metode. Istraživanje je sprovedeno na 27 kadavera, od kojih je 15 bilo ženskog a 12 muškog pola, sa ukupno 54 gornja ekstremiteta. Nakon pažljive disekcije, varijacije u mestu i načinu podele NR ispitane su i na levoj i na desnoj ruci. Analiza dobijenih podataka izvršena je pomoću kompjuterskog programa Microsoft Office Excel. Korišćena je klasifikacija po kojoj je podela NR na terminalne grane iznad biepikondilarne linije (BEL) definisana kao tip A, dok je podela NR ispod BEL definisana kao tip B. Rezultati. Prema predloženoj klasifikaciji, uočili smo veću zastupljenost tipa A (66,7%) u poređenju sa tipom B (33,3%) u ukupnom uzorku od 54 ekstremiteta. Osim toga, uočena je veća zastupljenost tipa A kod osoba ženskog pola, dok je kod muškaraca bio zastupljeniji tip B. Rezultati su pokazali i da postoji razlika u procentualnom udelu tipa A i tipa B između levih i desnih ekstremiteta ali varijacije u načinu završetka NR nisu bile utvrđene. Zaključak. Studija je pokazala značajnu složenost anatomije NR, sa važnim kliničkim posledicama. Imajući to u vidu, za svakog bolesnika neophodno je definisati granice ,,sigurne zoneˮ prilikom hirurških operacija u regionu lakta, čime će biti obezbeđena zaštita NR i njegovih završnih grana od jatrogene povrede.

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Objavljeno
2023/12/29
Broj časopisa
Vol. 80 Br. 12 (2023): Vojnosanitetski pregled
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