Anatomy of the Posterior Interosseous Nerve in Relation to Fixation of the Radial Head

Tornetta, Paul; Hochwald, Neal; Bono, Christopher M.; Grossman, Marc E.

doi:10.1097/00003086-199712000-00031

Cited by 57 publications

(45 citation statements)

References 9 publications

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“…Numerous authors have previously described the relationship of the radial nerve to local anatomic structures in an attempt to add clarity and precision to surgical approaches (Guse et al, 1995), Gerwin et al (1996), Uhl et al (1996), Bono et al (2000), Fleming et al (2004), Mekhail et al (1996), Tornetta et al (1997), and Hoppenfeld et al (2007). As previously described in studies by Chia et al (2009), Kamineni et al (2009), andWang et al (2009), these anatomic principles encompass a wide range of surgical procedures ranging from percutaneous pinning to intramedullary nail placement to compression plating.…”

Section: Discussionmentioning

confidence: 99%

“…Studies by Mekhail et al (1996), Tornetta et al (1997), andHoppenfeld et al (2007) have described the branching of the RN into the PIN and RSN as occurring in the cubital fossa near the radiohumeral joint line [6,7,10]. Average values found range from 1.2 mm 6 1.9 mm distal to 1.1 cm 6 1.0 cm proximal in relation to the radiohumeral joint [7,10].…”

Section: Discussionmentioning

confidence: 99%

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Predicting radial nerve location using palpable landmarks

et al. 2010

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The purpose of this study is to predict the location of radial nerve (RN) utilizing palpable anatomic landmarks. Thirty-four paired upper limbs were dissected. The RN was localized: (1) at the humeral spiral groove (SG), (2) lateral intermuscular septum (LIS), and (3) at its' division into the posterior interosseous nerve (PIN) and radial sensory nerve (RSN). The PIN was located at the anterior aspect of the radial neck (AN). Humeral and radial lengths were measured. The RN traversed the SG, on average, 48% (36%-63%) of humeral length, distal to the greater tuberosity. The RN pierced the LIS, on average, 38% (29%-56%) of humeral length, proximal to the lateral epicondyle (LE). The PIN/RSN division occurred on average 1.0 cm (-11.4 to 3.5) distal to the LE. The PIN crossed the AN, on average, 10% (5%-14%) of radial length, distal to the radial head articular surface.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predicting radial nerve location using palpable landmarks

et al. 2010

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“…It has also been shown that pronation of the forearm increases the distance between the PIN and the surgical approach when the posterior approach is used to expose the proximal radius (Strachan and Ellis, 1971;Tornetta et al, 1997;Witt and Kamineni, 1998;Diliberti et al, 2000). However, the nerve supply to the supinator itself has not been correlated with risk of nerve injury during the two-incision approach to distal biceps tendon repair.…”

Section: Discussionmentioning

confidence: 99%

Innervation of the supinator muscle and its relationship to two‐incision distal biceps tendon repair: An anatomic study

2010

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Reinsertion of the ruptured distal biceps tendon has been performed using either a single-anterior incision or a two-incision approach. A systematic review of these two repair methods has identified a higher incidence of supination weakness following the two-incision approach. The objective of this study was to describe the innervation of the supinator muscle and its implications regarding a two-incision distal biceps repair. Twelve fresh upper extremity specimens from 12 males were dissected with the forearm in full pronation. The number of branches of the posterior interosseous nerve (PIN) to the supinator, their site of exit from the PIN trunk, and their distance from a variety of known anatomic landmarks were recorded. Specimens were characterized as high (<5 mm), moderate (6-10 mm), or low (>10 mm) risk of nerve branch injury depending on the proximity of nerve branches to the bicipital tuberosity. In general, we found the innervation of the supinator to be highly variable. There were from two to nine branches of the PIN which supplied the supinator, with 0-3 arising from the ulnar side of the nerve. Four specimens were at low, five at moderate, and three at high risk of nerve branch injury during dorsal exposure of the bicipital tuberosity. We conclude that there is a substantial amount of variability in the innervation of the supinator, with certain patterns being at higher risk of nerve branch injury if dissection of the supinator is carried out over the bicipital tuberosity.

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“…Consequently, doctors are more careful during the surgical operation. The primary cause is the anatomical complexity of the approach (Tornetta et al, 1997;Calfee et al, 2011;Catalano et al, 2011;Jockel et al, 2013). Therefore, we aim to avoid iatrogenic injury of the deep branch of radial nerve by thoroughly understanding the anatomical features involved in the approach.…”

Section: Introductionmentioning

confidence: 99%

Anatomical Factors/Countermeasures in/against Iatrogenic Injury of the Deep Branch of Radial Nerve in the Thompson Approach Via Middle and Proximal Segments of Forearm

et al. 2017

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SHAN, J.; WANG, C.; REN, D. & JIANG, H.Anatomical factors/countermeasures in/against iatrogenic injury of the deep branch of radial nerve in the Thompson approach via middle and proximal degments of forearm. Int. J. Morphol., 35(1):92-98, 2017. SUMMARY:This study aimed to investigate the anatomical factors affecting iatrogenic injury of the deep branch of radial nerve during the Thompson approach and to propose corresponding countermeasures. Thompson approach was used to measure the horizontal/ longitudinal distance from the position where the deep branch of radial nerve leaves the supinator to the ulnar margin of extensor carpi radialis brevis/humeroradial joint line. Measurements were obtained by using 48 adult cadaver specimens, which were used in teaching. We observed the lentor situation of the extensor digitorum and extensor carpi radialis brevis in proximal forearm segments and measured the distance from the deep branch of radial nerve to the humeroradial joint line at the lateral side of the radius in the neutral position of forearm rotation. The horizontal distance from the point where the deep branch of radial nerve leaves the inferior margin of supinator to the ulnar margin of extensor carpi radialis brevis was 1.3 ± 0.3 cm. The distance to the humeroradial joint line was 61.3 ± 17.6 mm. The distance to the lentor extent of extensor digitorum and extensor carpi radialis brevis at the distal part of humeroradial joint was 7.1 ± 2.1 cm. The distance from the deep branch of radial nerve to the humeroradial joint line at the lateral side of the radius is 3.2 ± 0.6 mm. Anatomical factors are observed in iatrogenic injury of the deep branch of radial nerve during the Thompson approach. Stretching the extensor digitorum before the dissection of the supinator is hazardous.

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Anatomy of the Posterior Interosseous Nerve in Relation to Fixation of the Radial Head

Cited by 57 publications

References 9 publications

Predicting radial nerve location using palpable landmarks

Predicting radial nerve location using palpable landmarks

Innervation of the supinator muscle and its relationship to two‐incision distal biceps tendon repair: An anatomic study

Anatomical Factors/Countermeasures in/against Iatrogenic Injury of the Deep Branch of Radial Nerve in the Thompson Approach Via Middle and Proximal Segments of Forearm

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