Relation of radial nerve to superficial bony and soft tissue landmarks- a cadaveric study

Abstract

Background: Prevention of iatrogenic nerve injury during humerus fracture surgery would be of prodigious importance. Several methods were used to ease this type of injury but no flawless result is at hand. Therefore, this study was designed to predict the location of the radial nerve (RN) by bony as well as soft tissue landmarks and also identify the safe zone for RN in arm.Methods: Fifty upper limbs belonging to 25 cadavers with no macroscopic deformity of their elbow joint were dissected for the study. RN was dissected in the spiral groove of the humerus and measurements were taken from different anatomical landmarks.Results: There was no bilateral asymmetry as well as no statistical difference was observed in male and female measurements. The mean distance between olecranon to spiral groove 16.91±0.18 cm, olecranon to entry in Intermuscular septum 10.65±0.16 cm, triceps aponeurosis to RN in spiral groove 2.50±0.06 cm, medial epicondyle to upper margin of spiral groove 17.01±0.09 cm and lateral epicondyle to lower margin of spiral groove 10.97±0.12 cm was observed.Conclusions: Understanding the zone of danger of humerus provide more safety during surgical intervention of humerus by predicting the location of RN by different bony and soft tissue landmarks.

The anatomical relationship of the superficial branches of radial nerve: a cadaveric study

“…16 Intraoperatively to identify, locate and protect radial nerve, soft tissue landmark confluence of triceps aponeurosis is most consistent and reliable. 17 Proximal dissections of these branches allows the search of the perfect course of the radial nerve and acquaintance of the humeral shaft, both anteriorly and posteriorly to the lateral intermuscular septum. 18 This approach permits assessment of any part of the radial nerve and reduces the risk of iatrogenic injury.…”