The anatomical relationship of the superficial radial nerve and the lateral antebrachial cutaneous nerve: A possible factor in persistent neuropathic pain

Poublon, A.R.; Walbeehm, Erik T.; Duraku, Liron S.; Eilers, Paul H.C.; Kerver, Anton; Kleinrensink, G.J.; Coert, J. Henk

doi:10.1016/j.bjps.2014.10.010

Cited by 24 publications

(14 citation statements)

References 20 publications

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“…This is the first study where the DUN has been reported in association with LI4 with empirical evidence and observation. The findings of the SRN and DUN are also supported in other studies in different populations of cadavers (Abrams, Brown, & Botte, 1992;Beldner, Zlotolow, Melone Jr, Agnes, & Jones, 2005;Bini & Leclercq, 2020;Dellon & Mackinnon, 1984;Gil, Shin, Lee, Koh, & Song, 2016;Ikiz & Uçerler, 2004;Park, Bun, Hwang, Hong, & Kim, 2010;Poublon et al, 2015;Samarakoon et al, 2011;Umemoto et al, 2019). Generally, the SRN is known to supply the skin on digits 1 to 3 and the dorsal lateral half the ring finger as well as the dorsum of the hand to the wrist (Ikiz & Uçerler, 2004).…”

Section: Nerve Components In the Area Of Li4supporting

confidence: 77%

Anatomical characterization of acupoint large intestine 4

Casey

2021

The Anatomical Record

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Large intestine 4 (LI4) is a major acupoint used in various treatments in acupuncture and Traditional Chinese Medicine. There are structures associated within the region of LI4 that have three-dimensional anatomical relationship that needs further characterization. The aims of this study were: (a) to observe the anatomical variation of structures around LI4; (b) to observe specific overlap of structures around LI4. A 1256 mm 2 area was dissected in 25 cadaveric hands around LI4. Nondissected areas were marked with pins as reference points. Dissections were photographed with a fixed camera. Subsequently, images were imported to Adobe Photoshop 2020 and analyzed. Descriptive statistics and graphs were compiled using Graphpad Prism 2020. The tributaries of the dorsal venous plexus (22.3%), branches of superficial radial nerve (18.9%), first dorsal interosseous muscle (52.4%), arterial branches in the first interosseous space (10.2%), and deep ulnar nerve (4.0%) were observed in the area of LI4. One branch of the superficial radial nerve passed through LI4. The deep ulnar nerve was found in the bulk of the first dorsal interosseous muscle. Several structures observed intersected at LI4. The superficial radial nerve interweaved with the dorsal venous plexus superficially. The deep ulnar nerve passed anterior to the second palmar metacarpal artery before entering into the first dorsal interosseous muscle. These results provide anatomical evidence and variation into the vascular contributions at LI4.

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Section: Nerve Components In the Area Of Li4supporting

confidence: 77%

Anatomical characterization of acupoint large intestine 4

Casey

2021

The Anatomical Record

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“…Therefore, the LABCN was left out. However as seen in earlier studies[ 26 ] the close relation between the LABCN and SBRN could be a major contributor to the cause of neuropathic pain in the distal wrist.…”

Section: Resultsmentioning

confidence: 77%

“…As postulated in an earlier study[ 26 ], iatrogenic nerve damage to these nerves can lead do debilitating neuropathic pain symptoms[ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Optimal surgical approach for the treatment of Quervains disease: A surgical-anatomical study

Poublon¹,

Kleinrensink²,

Kerver³

et al. 2018

WJO

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AIMTo determine which of the common used incision techniques has the lowest chance of iatrogenic damage to the nerves which at risk are the superficial branch of the radial nerve (SBRN) and the Lateral Antebrachial Cutaneous Nerve (LABCN).METHODSTwenty embalmed arms were dissected and the course of the SBRN and the LABCN in each individual arm was marked and the distance between the two branches of the SBRN at the location of the First Extensor Compartment (FEC) was measured. This data was used as input in a visualization tool called Computer Assisted Anatomy Mapping (CASAM) to map the course of the nerves in each individual arm.RESULTSThis image visualizes that in 90% of the arms, one branch of the SBRN crosses the FEC and one branch runs volar to the compartment. The distance between the two branches was 7.8 mm at the beginning of the FEC and 10.2 mm at the end. Finally the angle of incision at which the chance of damage to the nerves is lowest, is 19.4 degrees volar to the radius.CONCLUSIONCASAM shows the complexity of the course of the SBRN over the FEC. None of the four widely used incision techniques has a significantly lower chance of iatrogenic nerve damage. Surgical skills are paramount to prevent iatrogenic nerve damage.

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“…Despite validating preoperative nerve blocking was performed to exclude pain from overlapping nerves such as the LACN (Mackinnon & Dellon, ) postoperative mutual interference resulting in unsatisfying pain release cannot be excluded. The anatomical proximity between the SBRN and the LACN in the distal third of the wrist might contribute to persisting postoperative neuropathic pain (Poublon et al, ) as observed in two patients (not shown in “Results”). In both patients the diagnostic nerve blocks, with a special attribute to the LACN, were repeated, but no considerable pain reduction could be achieved.…”

Section: Discussionmentioning

confidence: 87%