Anatomy of the posterior branch of the medial antebrachial cutaneous nerve: A cadaveric study

Manoukov, Y.; Herisson, Olivier; Sali, Eric; Sautet, Alain; Masquelet, Alain-Charles

doi:10.1016/j.otsr.2020.02.006

Cited by 2 publications

(5 citation statements)

References 23 publications

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“…Race and Saldana [ 3 ] suggested that the MACN was distributed into 1–3 branches anteriorly innervating the proximal medial forearm, whereas 3–7 branches passed posteriorly, close to the cubital tunnel. In a cadaveric study by Manoukov et al [ 7 ], the PBMACN was detected in all cases, with an average of 1.32 secondary branches. In our study, the average number of MACN branches was 2.18±1.00, the number of secondary branches of the ABMACN was 1.60±0.78, and that of the secondary branches of the PBMACN was 1.07±0.25.…”

Section: Discussionmentioning

confidence: 99%

“…As previous cadaveric studies have demonstrated, the course and number of MACN branches are highly variable [ 1 , 3 , 5 – 7 ]. Tanaka and Lourie [ 5 ] suggested that the PBMACN can be subdivided into 1–4 branches (mean, 2.07).…”

Section: Discussionmentioning

confidence: 99%

“…In a cadaveric study, Manoukov et al [ 7 ] investigated the relationship between the PBMACN and other major anatomical landmarks. However, their measurement method was different from that used in this study.…”

Section: Discussionmentioning

confidence: 99%

“…If the examination is performed with the elbow in a flexed position, subluxation or dislocation of the ulnar nerve could occur; however, this was not considered in our study. Manoukov et al [ 7 ] suggested that when the elbow was flexed 90°, the incision site in cubital tunnel release surgery was distant from the PBMACN. However, when the elbow was flexed 45°, the incision site crossed the MACN location, increasing the risk of injury.…”

Section: Discussionmentioning

confidence: 99%

“…In the arm, the MACN courses between the brachialis and triceps brachii muscles, and becomes subcutaneous at the distal or mid-brachial level running close to the basilic vein (BV) [1,[3][4][5]. Between the mid-and lower thirds of the arm, the MACN passes the basilic hiatus with the BV and commonly divides into the anterior branch (ABMACN) and posterior branch (PBMACN) [1,2,[6][7][8]. After piercing the brachial fascia at the elbow, the AB-MACN anteriorly crosses the elbow between the biceps tendon and medial epicondyle (ME) [1,9].…”

mentioning

confidence: 99%

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Ultrasonographic Identification of the High-Risk Zone for Medial Antebrachial Cutaneous Nerve Injury in the Elbow

Kim

Yoon

2022

Ann Rehabil Med

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Objective To demonstrate the sonoanatomy of the medial antebrachial cutaneous nerve (MACN) in the elbow region using high-resolution ultrasonography (HRUS) to identify areas at a high risk of MACN injury.Methods A total of 44 arms were included in the study. In the supine position, the participants’ arms were abducted 45° with the elbow fully extended. The MACN was visualized in the transverse view. The anterior branch of the MACN (ABMACN), posterior branch of the MACN (PBMACN), and location of the branching sites were determined. The distance between the ABMACN and superficial veins, including the basilic vein (BV) and median cubital veins (MCV) was measured. For the PBMACN, the distance to the ulnar nerve (UN) and to BV were measured.Results The MACN was subdivided into 2.18±1.00 branches, including ABMACN and PBMACN. The ABMACN and PBMACN were subdivided into 1.60±0.78 and 1.07±0.25 branches, respectively. The branching point of the MACN was 8.40±2.42 cm proximal to the interepicondylar line (IEL). We demonstrated that the ABMACN is located close to the BV and MCV in the elbow region, and the PBMACN was located approximately 1 cm and 0.8 cm anterior to the UN and posterior to the BV at the IEL level, respectively.Conclusion Considering the location of the MACN, including ABMACN and PBMACN, clinicians can perform invasive procedures around the elbow region more carefully to lower the risk of MACN injury.

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Section: Discussionmentioning

confidence: 99%