Anatomic considerations regarding the posterior interosseous nerve at the elbow

Variations in the Anatomic Relations of the Posterior Interosseous Nerve Associated with Proximal Forearm Trauma

“…Each distal wire was placed parallel to the proximal capitellar wire. This method was similar to that reported by Lawton et al 1 . Correct wire placement was confirmed before data collection by visually verifying that the suture, when tensioned, indeed marked the axis of the radius.…”

“…Safe distances for dissection, within which exposure does not require visualization of the posterior interosseous nerve, have been reported to be as much as 4 cm distal to the radiocapitellar joint 1 , as much as 5 cm distal to the lateral epicondyle 2 , or proximal to the distal extent of the bicipital tuberosity 3 . Other investigators have recommended identifying and protecting this nerve in all cases 4 .…”

“…To this end, investigators have conducted numerous cadaveric investigations to determine the longitudinal and cross-sectional anatomic relationships of the posterior interosseous nerve. The location of the posterior interosseous nerve relative to osseous and softtissue landmarks 1,3,5,6 , and the effects of forearm rotation on the posterior interosseous nerve 1,2,4,5 , have been studied in skeletally intact specimens.…”

“…Although previous studies have evaluated the position of the posterior interosseous nerve relative to landmarks likely to be preserved despite trauma to the proximal aspect of the radius (e.g., the articular surface of the capitellum), there have been no prior studies that have examined the posterior interosseous nerve in a model of simulated proximal forearm trauma 1,[4][5][6][7] , to our knowledge. This study was designed to quantify the effect of a simulated diaphyseal fracture of the proximal one-third of the radius, and the effect of a radial neck fracture with an EssexLopresti injury, on the anatomic relationships of the posterior interosseous nerve.…”

“…Discussion P revious investigations have described the normal structure and course of the posterior interosseous nerve and have elucidated changes in nerve position as a function of forearm rotation 1,2,4,5 . Notably, these prior measurements were uniformly recorded in skeletally intact specimens .…”