The Role of the Musculocutaneous and Radial Nerves in Elbow Flexion                     and Forearm Supination: A Biomechanical Study

Roukoz, Sami; Naccache, Nicole; Sleilaty, Ghassan

doi:10.1177/1753193408087036

Cited by 12 publications

(5 citation statements)

References 8 publications

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“…In electromyographic studies of forearm supination, the supinator muscle was the most active one in unresisted supination, showing increased biceps activity with heavy loading [21]. Selective denervation of the supinator muscle by peripheral blockade of the radial nerve with preserved biceps function via the musculocutaneous nerve has been shown to decrease the supination strength by 64% [22]. These findings might support previous studies that compared clinical results of biceps tenotomy with that of tenodesis.…”

Section: Discussionsupporting

confidence: 76%

Residual rotation of forearm amputation: cadaveric study

Lee

Kim

et al. 2020

BMC Musculoskelet Disord

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Background: The purpose of this study was to investigate residual rotation of patients with forearm amputation and the contribution of involved muscle to residual rotation. Methods: Testing was performed using five fresh-frozen cadaveric specimens prepared by isolating muscles involved in forearm rotation. Amputation was implemented at 25 cm (wrist disarticulation), 18 cm, or 10 cm from the tip of olecranon. Supination and pronation in the amputation stump were simulated with traction of involved muscle (supinator, biceps brachii, pronator teres, pronator quadratus) using an electric actuator. The degree of rotation was examined at 30°, 60°, 90°, and 120°in flexion of elbow. Results: Average rotation of 25 cm forearm stump was 148°(SD: 23.1). The rotation was decreased to 117.5°(SD: 26.6) at 18 cm forearm stump. It was further decreased to 63°(SD 31.5) at 10 cm forearm stump. Tendency of disorganized rotation was observed in close proximity of the amputation site to the elbow. Full residual pronation was achieved with traction of each pronator teres and pronator quadratus. Although traction of supinator could implement residual supination, the contribution of biceps brachii ranged from 4 to 88% according to the degree of flexion. Conclusions: Close proximity of the amputation site to the elbow decreased the residual rotation significantly compared to residual rotation of wrist disarticulation. The preservation of pronosupination was 80% at 18 cm forearm stump. Although the pronator teres and the pronator quadratus could make a full residual pronation separately, the supinator was essential to a residual supination.

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Section: Discussionsupporting

confidence: 76%

Residual rotation of forearm amputation: cadaveric study

Lee

Kim

et al. 2020

BMC Musculoskelet Disord

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“…In electromyographic studies of forearm supination the supinator muscle was the most active in unresisted supination, with increasing biceps activity with heavy loading (Gordon et al, 2004). Selective denervation of the supinator muscle by peripheral blockade of the radial nerve with preserved biceps function via the musculotaneous nerve has been shown to decrease supination strength by 64% (Roukoz et al, 2008). The finding of an increased rate of persistent supination weakness following a two-incision distal biceps repair may have multiple causes, which theoretically include direct injury to the supinator muscle, as well as partial or complete denervation of the supinator muscle during the posterior exposure of the tuberosity.…”

Section: Introductionmentioning

confidence: 98%

Innervation of the supinator muscle and its relationship to two‐incision distal biceps tendon repair: An anatomic study

2010

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Reinsertion of the ruptured distal biceps tendon has been performed using either a single-anterior incision or a two-incision approach. A systematic review of these two repair methods has identified a higher incidence of supination weakness following the two-incision approach. The objective of this study was to describe the innervation of the supinator muscle and its implications regarding a two-incision distal biceps repair. Twelve fresh upper extremity specimens from 12 males were dissected with the forearm in full pronation. The number of branches of the posterior interosseous nerve (PIN) to the supinator, their site of exit from the PIN trunk, and their distance from a variety of known anatomic landmarks were recorded. Specimens were characterized as high (<5 mm), moderate (6-10 mm), or low (>10 mm) risk of nerve branch injury depending on the proximity of nerve branches to the bicipital tuberosity. In general, we found the innervation of the supinator to be highly variable. There were from two to nine branches of the PIN which supplied the supinator, with 0-3 arising from the ulnar side of the nerve. Four specimens were at low, five at moderate, and three at high risk of nerve branch injury during dorsal exposure of the bicipital tuberosity. We conclude that there is a substantial amount of variability in the innervation of the supinator, with certain patterns being at higher risk of nerve branch injury if dissection of the supinator is carried out over the bicipital tuberosity.

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“…The tendon of the LHB has a rounded shape, is surrounded by the synovial membrane, and traverses the intertubercular groove at the proximal humeral joint. Its function is to depress the humeral head in the glenoid; it performs supination of the forearm and performs elbow flexion when the forearm is supinated (1) .…”

Section: Introductionmentioning

confidence: 99%

Tenotomy With or Without Tenodesis of the Long Head of the Biceps Using Repair of the Rotator Cuff

Ikemoto

Pileggi²,

Murachovsky

et al. 2012

Revista Brasileira de Ortopedia (English Edition)

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Objective: To compare the functional results among patients undergoing tenotomy with or without tenodesis of the long head of the biceps associated with arthroscopic repair of rotator cuff injuries, with a minimum two-year follow-up. Method: This was a retrospective non-randomized trial with evidence level III, in which the medical files of 77 patients with lesions of the long head of the biceps were reviewed and clinically reassessed. Among these, 55 patients underwent tenotomy without tenodesis and 22 underwent tenotomy with tenodesis, with outpatient follow-up for at least two years. The age, dominant side, operated side, lesion size using the Gartsman classification, pre and postoperative range of motion, presence or absence of the Popeye sign, pain in the bicipital groove and assessments using the University of California at Los Angeles (UCLA) score and the elbow strength index. Results: The mean UCLA score of the sample went from 16.92 (range: 8 to 25) to 31.45 (range: 13 to 35) (p < 0.001). Comparison of the pre and postoperative UCLA scores in the two groups showed that the difference in the group with tenotomy and tenodesis was 15.95 and in the group with tenotomy alone, 14.62 (p = 0.023). However, there was no statistical significance in comparing the groups regarding pain in the bicipital groove, Popeye sign or elbow strength index. Conclusion: This study showed that the difference in UCLA scores was statistically significant. The group with tenotomy and tenodesis of the long head of the biceps presented better functional results.

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The Role of the Musculocutaneous and Radial Nerves in Elbow Flexion and Forearm Supination: A Biomechanical Study

Cited by 12 publications

References 8 publications

Residual rotation of forearm amputation: cadaveric study

Residual rotation of forearm amputation: cadaveric study

Innervation of the supinator muscle and its relationship to two‐incision distal biceps tendon repair: An anatomic study

Tenotomy With or Without Tenodesis of the Long Head of the Biceps Using Repair of the Rotator Cuff

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