Study Of Denervation In The Treatment Of Proximal Interphalangeal Joint On The 2?5 Fingers

Objective: This study is to research the sensory nerve branch of Proximal Interphalangeal Joint(PIP)from 2 to 5 anatomic distributions,and hopes to provide anatomical basis and support for the treatment of bone pain to nerve.Method: Dissect the PIP palmar and dorsal articular branches of 2-5 fingers from 10 adult upper limb specimens under the microscope,observe the origin,the evolutionary plane and shape changing rule,measure the diameter,amount and length of the joint.All acquired datum were analyzed by SPSS20.0.Result:(1)The origin of PIP palmar and dorsal articular branches of 2-5fingers: PIP palmar branch is originated from proper digital nerve.PIP dorsal branch is originated from dorsal branch of the proper digital nerves.(2)The evolutionary plane and shape changing rule of PIP palmar and dorsal articular branches of 2-5 fingers: PIP palmar intrinsic nerve branches of 2~5 fingers are evoluted from the 1/3 of the proximal segment and 1/3 of the median segment,the proximal articular branch is moving to the palm plate,the distal articular branch is moving toward the reverse.The dorsal intrinsic nerve branches evoluted from the 1/3 of the distal segment and moves toward the dorsal joint capsule.Dorsal digital nerves started from the dorsal branch of musculospiral nerve or ulnar nerve and stopped in the middle of proximal phalanx,no evoluted PIP dorsal joint branch was observed.(3)The diameter of PIP palmar and dorsal articular branches of 2-5 fingers: The diameters are different in the PIP palmar and dorsal articular branches of 2-5 fingers,the maximum is 0.86 mm and the minimum is 0.26 mm.The difference of branch's diameters are statistically significant.(P <0.05)(4)The quantity of PIP palmar and dorsal articular branches of 2-5 fingers: Proper digital nerves evolute branches toward the palm plate with 2-5 branches each side.Proper digital nerves evolute branches toward the dorsal joint capsule with also 2-5branches each side.The difference of branch's diameters are not statistically significant.(P > 0.05)(5)The length of PIP palmar and dorsal articular branches of 2-5 fingers: The length of radial palmar articular branches of 2~5fingers is 0.72 ~ 1.40 cm,the length of ulnar palmar articular branches of 2~5fingers is 0.48 ~ 1.42 cm,the length of radial dorsal articular branches of 2~5fingers is 0.42 ~ 0.84 cm.Compare the different lengths of each articular branches,The difference of branch's diameters are not statistically significant.(P >0.05)Conclusion: The palmar and dorsal side of PIP of 2~5 fingers are all dominated by the arthrosensory nerv.PIP palmar branch is originated from proper digital nerve.PIP dorsal branch is originated from dorsal branch of the proper digital nerves.The origin,the evolutionary plane and shape changing rule are all have certain routines.From the aspect of anatomy,using denervation to treat proximal interphalangeal joint pain on the 2-5 fingers is feasible,the operation is simple and minimally invasive.