Arborization of the distal posterior interosseous nerve

McCarthy, Clare Kearns; Breen, Thomas F.

doi:10.1016/s0363-5023(05)80010-3

Cited by 10 publications

(4 citation statements)

References 8 publications

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“…The methodology of our study did not allow the conclusion that all of these branches innervate the MCP joints, but the number of PIN nerve branches that run through the metacarpals was undoubtedly greater. McCarthy et al [17] showed that 14 of 41 (34%) specimens in which the 3.5× magnification of PIN dissection was performed, had innervations of terminal branches that included the CMC joints, the interossei, and the metacarpal periosteum. They also observed three levels of innervation that were present in most specimens: radiocarpal, midcarpal, and terminal branches.…”

Section: Discussionmentioning

confidence: 99%

Assessing the innervation of the dorsal wrist capsule using modified Sihler’s staining

Bonczar

Walocha

Bonczar³

et al. 2021

Folia Morphol

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Background: The aim of this study was to assess the innervation of the dorsal articular capsule of the wrist using modified Sihler's staining. Materials and methods: Thirty dorsal wrist capsules were collected from 15 donors (both sides) within 12 hours of death. All the capsules were collected in the same mannerusing the dorsal incision. The specimens were stained according to the protocol of the modified Sihler's staining technique. The preserved capsules were analyzed under 8-16× magnification of an optical microscope for the presence of major nerve trunks, their major and minor branches, and nerve connections. Results: The range of innervation visualized was that the posterior interosseous nerve innervated approximately 60% of the central part; the remaining area was innervated by the dorsal sensory branch of the radial nerve and medial antebrachial cutaneous nerve. The constant findings were the branches departing from the ulnar side of the posterior interosseous nerve and from the radial side, with an exception seen in two cases. A communicans branch between the posterior interosseous nerve and medial antebrachial cutaneous nerve was seen in all the specimens. The posterior interosseous nerve innervation extended beyond the level of the carpometacarpal joints II-V. Conclusions: The modified Sihler's staining technique allows for transparent visibility of the nerves that innervate the dorsal wrist capsule. However, it does not allow as accurate assessment as does histological examination, especially regarding the evaluation of nerve endings. Nevertheless, this method provides a significantly larger area of nerve observation than is provided by histological examination.

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Section: Discussionmentioning

confidence: 99%

Assessing the innervation of the dorsal wrist capsule using modified Sihler’s staining

Bonczar

Walocha

Bonczar³

et al. 2021

Folia Morphol

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“…There is no mention of them in the detailed anatomic study of the distal PIN of McCarthy and Breen. 4 Those branches may have a role in posttraumatic pain after distal radius fractures. The role of PIN in wrist pain and in fractures at the level of the wrist is well-established: The PIN is the main articular branch on the dorsal part of the carpus.…”

Section: Discussionmentioning

confidence: 99%

A Cadaveric Study of the Posterior Interosseous Nerve and Its Branches at the Level of the Distal Radius

Grégory

Goutard

Grégory

et al. 2019

Journal of Hand Surgery Global Online

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Posterior interosseous nerve (PIN) damage has been cited as a cause of wrist pain syndrome after distal radius fractures. The goal of this cadaveric study was to examine this hypothesis by looking for branches between the PIN and the periosteum of the distal radius. Methods: The PIN was dissected in 10 adult specimens (8 fresh and 2 embalmed) under Â2.5 magnification. All of the dissections started from the last motor branch of the PIN, innervating the extensor indicis proprius, and proceeded from proximal to distal. Results: The PIN was divided into 3 terminal segments in the dorsal wrist joint (proximal, middle, and distal segments). We were able to observe that branches to the distal radial periosteum were constant and emerged from the middle segment where the nerve is enclosed in a sturdy fibro-fatty sheath adhered to the dorsal periosteum of the distal radius. No collateral bundle was identified in the proximal segment. In the distal segment, every specimen had branches to the radiocarpal joint; 9 of 10 had a midcarpal innervation. Terminal branches to the carpometacarpal joints were identified in 2 cadaveric wrists. Conclusions: The radial periosteum PIN branches consistently identified in these specimens may contribute to dorsal wrist pain seen at the time of late follow-up in patients after distal radius fractures. Clinical relevance: The benefit of PIN denervation as an adjuvant procedure should be evaluated further in the surgical management of wrist injuries.

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“…Several anatomic studies have been published on the PIN, describing its size, location, and the number of fascicular bundles. 15,16 At the level of the extensor retinaculum, the PIN is usually found on the radial wall of the fourth compartment. Just distal to the radiocarpal joint, the PIN divides into three to four terminal branches to supply the midcarpal joint and distally reaching the second, third, and fourth carpometacarpal joints.…”

Section: Discussionmentioning

confidence: 99%

“…First, the PIN is the main articular branch on the dorsal part of the wrist. It innervates the radiocarpal, midcarpal, the carpometacarpal joints, 16 and has no cutaneous innervation. There is no cutaneous sensory loss after injury.…”

Section: Discussionmentioning

confidence: 99%

The Course of the Terminal Posterior Interosseous Nerve and Its Relationship with Wrist Arthroscopy Portals

Pan

Hung

2016

Jnl Wrist Surg

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Wrist arthroscopy has been used extensively in recent years as both a diagnostic and therapeutic procedure.1,2 Dorsal portals are regularly used. Although the periportal anatomy has been well described, 3-8 complications do occur. AbstractPurpose The terminal branches of the posterior interosseous nerve (PIN) are the main articular branch on the dorsal aspect of the wrist. Its relationship to dorsal wrist arthroscopic portals has not yet been elucidated. The purpose of this study was to quantitatively describe the anatomical relationships between the dorsal wrist arthroscopic portals and the PIN. Methods Dorsal wrist arthroscopic portals were established in 28 cadaver extremities, after which the limbs were dissected. Measurements were taken from the portals to the PIN. Results The PIN passed ulnar to the 3/4 portal with a mean distance of 4.8 mm (range: 1.2-12.0, standard deviation [SD] ¼ 2.6). The PIN passed radial to the 4/5 portal with a mean interval of 9.0 mm (range: 3.8-12.7, SD ¼ 2.3). The main trunk of PIN or its closest terminal branch was a mean of 7.2 mm (range: 0.0-13.2 mm, SD ¼ 3.1) radial to the midcarpal radial (MCR) portal. In 2 of the 28 specimens, one terminal branch of PIN lay directly over this portal. The distance between the midcarpal ulnar (MCU) portal and the PIN or its closest terminal branch was only a mean of 1.6 mm (range: 0-6.4 mm, SD ¼ 2.0). In 15 of the 28 specimens, the PIN lay directly over the MCU portal, or the portal was located between the terminal branches of PIN. Conclusion The MCU portal was the most precarious, due to the close proximity of PIN and its terminal branches. The 3/4 and MCR portals were also at risk, while the 4/5 portal was relatively safe for the PIN.

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Arborization of the distal posterior interosseous nerve

Cited by 10 publications

References 8 publications

Assessing the innervation of the dorsal wrist capsule using modified Sihler’s staining

Assessing the innervation of the dorsal wrist capsule using modified Sihler’s staining

A Cadaveric Study of the Posterior Interosseous Nerve and Its Branches at the Level of the Distal Radius

The Course of the Terminal Posterior Interosseous Nerve and Its Relationship with Wrist Arthroscopy Portals

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