Innervation of the Proximal Interphalangeal Joint: An Anatomical Study

Pastrana, Martín José; Zaidenberg, Ezequiel Ernesto; Palumbo, Dante; Cesca, Fernando Juarez; Zaidenberg, Carlos Rodolfo

doi:10.1016/j.jhsa.2018.07.014

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…A mixed palmar-dorsal approach or a bilateral mid-lateral approach exposing both sides of the PIP joint are necessary to fully select palmar and dorsal nervous contingencies. Our results from the origin of nerve branches for PIP joint are supported by the Gray and Gardner [20] fetal study with silver staining, who found also a participation of dorsal nerves. Pastrana [20], also found in his anatomic study a dorsal contingency but only for the little finger.…”

Section: Discussionsupporting

confidence: 87%

“…Our results from the origin of nerve branches for PIP joint are supported by the Gray and Gardner [20] fetal study with silver staining, who found also a participation of dorsal nerves. Pastrana [20], also found in his anatomic study a dorsal contingency but only for the little finger. We found dorsal branches for the fourth and the fifth finger.…”

Section: Discussionsupporting

confidence: 87%

“…PIPs joints have a mixed innervation, from palmar and from dorsal digital nerves. Palmar branches detached from the main trunk about 8-17 mm [20], from the joint line and directly reach the joint capsule and the head on the proximal phalanx with an emergency angle of 20°-45° [20], passing Fig. 9 Visualization under the forceps of the palmar cutaneous branch of the median nerve for TMC.…”

Section: Discussionmentioning

confidence: 99%

“…We found dorsal branches for the fourth and the fifth finger. According to Pastrana [20], we consider these branches as the terminal branches of the dorso-ulnar sensory nerve.…”

Section: Discussionmentioning

confidence: 99%

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Innervation of digital joints: an anatomical overview

et al. 2021

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Introduction The innervation of the digital joints as well as the anatomical relationships of the articular branches is present in this anatomical work to determine the technical feasibility of a selective and efficient denervation of the digital joints. Materials and methods A study of 40 distal interphalangeal (DIP), 40 proximal interphalangeal (PIP), 50 metacarpophalangeal (MCP), 10 interphalangeal (IP) of the thumb, and 10 trapezo-metacarpophalangeal (TMC) joints was performed on ten hands. Under magnification and a proper surgical approach, we collected the course, the source origin, the number of articular nerve branches, and their caliber. Results In total, 118 nerve branches arising from the proper palmar digital nerves were found on 10 DIP of each dissected long finger (n = 40). A total of 226 nerve branches were found on 10 PIPs of each long finger (n = 40), of which 204 branches (90.3%) had a palmar origin. Dorsal innervation was found for the ring and little finger, originating from the dorso-ulnar digital nerve. 212 branches were found on 10 MCP of long fingers (n = 40), including 87 branches of palmar origin (41.1%), 107 branches of dorsal origin (50.4%), and 18 branches of the motor branch of the ulnar nerve (8.5%). 42 articular branches directed to the TMC joint (n = 10) were found. 13 branches (31%) originated from the anterior sensory branch of the radial nerve, 13 branches (31%) originated from the lateral cutaneous nerve of the forearm, 5 branches (12%) originated from the palmar cutaneous branch of the median nerve, and 11 (26%) branches originated from the thenar branch of the median nerve. The involvement of the sensory anterior branch of the radial nerve was always present for the innervation of each TMC. Discussion and conclusion Our research shows that finger joints receive their primary innervation from small branches of the digital nerves with the exception of the MCP joint and the TMC joint. To obtain an efficient and a selective digital denervation for articular pain relief, it is necessary to plan the best surgical approach and it is crucial to recognize the articular nervous branch localization and source.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

“…We found dorsal branches for the fourth and the fifth finger. According to Pastrana [20], we consider these branches as the terminal branches of the dorso-ulnar sensory nerve.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations