Localisation of the radial nerve at the spiral groove: A new technique

Abstract

SummaryBackgroundLocalisation of the radial nerve (RN) in the spiral groove by previously reported methods has a wide range and is generalised. The objective of this study was to establish a method unique to a patient to accurately localise the nerve.MethodsThe distance between RN at the midpoint of the spiral groove (D) and the tip of the olecranon (O) was compared with the most distal wrist flexion crease and fingertips on 100 healthy volunteers. The RN was found by ultrasound examination.ResultsThe mean distance from O to D was 16.22 cm (12.5–20.5 ± 1.55), and mean distances from wrist crease (WC) to second, third, fourth and fifth fingertips were 17.79 (14–20 ± 1.28), 18.66 (15–21 ± 1.32), 17.71 (14.5–20.5 ± 1.32) and 15.62 (12.5–20.5 ± 1.34) cm, respectively. With regards to O–D distance, the strongest relationship was obtained for the distance between the fifth fingertip to the WC (r = 0.708, p < 0.001). This relationship was stronger among females than males (p < 0.001).ConclusionThe course of the RN can be easily found at the upper arm by this method, which is unique to a patient.The translational potential of this articleThis study presents a new and individualised approach to accurately predict the location of the RN in the spiral groove. This method is clinically relevant and can be used to guide the surgical explorations or expedite interventional methods.

The radial nerve at revision/redo surgery – using the lower lateral cutaneous nerve to prevent a postoperative radial nerve deficit

“…A summary of prior studies is given in Table I . 1 , 2 , 3 , 4 , 6 , 7 , 8 , 9 , 10 , 12 , 14 , 15 , 17 , 19 , 22 , 23 …”

“…(Never within 100 mm of either epicondyle.) 7 Demirkale İ, İmamoğlu H, Şık S, et al 7 2019 Radiological/ anthropometric ultrasound assessment on healthy volunteers (100) Distance between radial nerve at the midpoint of the spiral groove and the tip of the olecranon was compared with the distance between the most distal wrist flexion crease and fingertips The distance between the Radial n at the midpoint of the sagittal groove and the tip of the olecranon correlated with the distance between the tip of the 5th finger and the distal wrist crease. 8 Fleming P, Lenehan B, Sankar R, et al 8 2004 Cadaveric(20) Bony landmarks – line joining lateral epicondyle and the most lateral point of the acromion process.…”

“…It is interesting to note that only two studies by Arora et al 1 (60 patients) and Gerwin M et al 9 (7 patients) have used intraoperative observations along with concurrent cadaveric studies. Studies by Demirkale et al, 7 Park et al, 16 Simone et al, 21 and Seigerman et al 19 have used intraoperative images to illustrate their landmarks and have quoted from personal clinical experience but have not corroborated the benefit of using said landmarks as a surgical outcome in a series of patients.…”