Anatomical study on the distribution of supraclavicular nerve in the supraclavicular region

Abstract

Objective To study the distribution of supraclavicular nerve in supraclavicular region and provide reference for operation. Methods Prospective study. From September 2017 to December 2018, 30 patients with clavicle fractures, including 16 males and 14 females, aged from 18 to 46 years old, had completed the anatomy of the supraclavicular nerve in the Surgery of Fracture Reduction and Internal fixation in the Fifth Department of Orthopaedic, the First Central Hospital of Baoding City. The supraclavicular incisions were taken in all the 30 patients(30 sides), and the branches of the supraclavicular nerves were carefully separated during the operation.The number of nerve branches in each patient was counted and its course and distribution in the supraclavicular region was studied. The branches of the supraclavicular nerve were marked by kirs needle across the supraclavicular border. The midpoint line at both ends of the clavicle was used as the collarbone transverse axis. Take the full length of the collarbone transverse axis as unit . The medial end of the collarbone transverse axis was taken as 0 and the lateral end as . C arm X-ray machine were used to measure the distance from the mark point of each branch of the supraclavicular nerve to the point of , and then the differences in the specific locations of the distribution of internal and external branches with different branch numbers were compared. Results Regional anatomy of the clavicle showed that 15 patients had three supraclavicular nerve branches (internal, middle and external branches), 14 patients had two nerve branches (internal and external branches), and 1 patient had one nerve branch (middle branch). The anatomical observation results of 15 patients with three branches by relative measurement method showed that the lateral branch appeared in 0.64±0.081, the intermediate branch appeared in 0.47±0.12, and the medial branch appeared in 0.27±0.08. The anatomic observation results of 14 patients with two branches showed that the lateral branch appeared in 0.61±0.07 and the medial branch appeared in 0.30±0.07. Anatomical observation of one branch showed that the intermediate branch appeared in 0.57. There was no statistically significant difference in the distribution of the three nerve branches (all P values>0.05). Conclusions The supraclavicular nerve has a regular distribution in the supraclavicular region. This study provides a basis to avoid injury of supraclavicular nerve in the fixation surgery and the second stage plate removal surgery. Key words: Supraclavicular nerve; Clavicle; Fracture fixation, internal; Surgical injury; Anatomy