The Superficial Branch of the Radial Nerve: A Morphologic Study

Abstract

Study the morphology of the superficial branch of the radial nerve (SBRN) of the forearms and wrists of fresh adult human cadavers. Methods: Twenty three dissections were performed under 3.5x loupe magnification, histological sections of the nerve were obtained in 20 dissections for fascicle identification. Results: The SBRN emerged, in average, at 8.65cm proximal to the radial styloid apophysis (RSA) between the Brachioradialis (BR) and Extensor Carpi Radialis Longus (ECRL) tendons. In 6/23 cases the SBRN emerged between an accessory BR tendon and the main BR tendon. The first branch of the SBRN arose at an average of 4.58 cm proximal to the RSA. A branch running across the RSA was found in 7/23 cases. At that level, the average number of branches crossing the wrist was 3.4. A fascicle count of the nerve and its first branch showed an average of 6.6 and 4.0 fascicles, respectively. Conclusion: Our anatomical findings are similar to those in the revised literature and contribute towards a better knowledge of the SBRN. Great caution is required in surgical procedures such as percutaneous bone fixation of the distal 1/3 of the forearm and wrist and particularly, in those susceptible to SBRN injury, as in seven of the 23 cases the SRBN ran directly accross the RSA. The authors recommend performing small longitudinal incisions down to the subcutaneous tissue, separating the nerve branches by blunt soft tissue dissection, with a delicate haemostat, before introducing the Kirschner wires (minimally invasive procedures).

Transfer of the Dorsal Cutaneous Branch of the Ulnar Nerve for Restoration of Median Nerve Sensation: A Cadaveric Study

“…Currently, a common option of restoring median nerve function is the transfer of the superficial radial nerve. The SRN has similar fascicle counts to our reported values from the DCBUN branches (6.6 for the SRN and 4.0 for its branches) (Folberg et al, ) and has been successfully used for MN sensory restoration (Ozkan et al, ). It is important to consider that the DCBUN's inequivalent fascicle counts compared to the MN's CDNs may make them less desirable than donor nerves with more similar histological characteristics to the MN's CDNs.…”

An Anatomical Study to Demonstrate the Proximity of Kirschner Wires to Structures at Risk in Percutaneous Pinning of Distal Radius Fractures

“…While it is mentioned time and again in literature to make stab-/ mini-incisions and going up to the bone surface before drilling the K-wires, in practice, it is often seen that K-wires are shoved in blindly through intact skin while performing percutaneous pinning [2,6,13]. The complex anatomy of the superficial nerves at the wrist, their branching pattern, overlap, and intercommunication has been extensively studied [6,7,9,10,17,[21][22][23][24]. Some of these patterns are not well known to the wrist surgeons and may easily be missed.…”

“…According to Singh et al [18] the incidence of superficial nerve injury in radial styloid pinning may be as high as 20 %. Most studies advocate making a stab incision and carefully retracting the soft-tissues out of harm's way while inserting K-wires percutaneously [5,6,8,9,11,13,15,[19][20][21]. However, in practice, it is often seen that K-wires are shoved in blindly through intact skin while performing percutaneous pinning [2,6,13].…”

Comunicación Masiva del Ramo Superficial del Nervio Radial con el Nervio Cutáneo Antebraquial Lateral, un Análisis Morfométrico. 1+1 ≤ 2

“…En nuestro estudio observamos que NRS presenta 9 fascículos, dato que coincide con lo comunicado por Folberg et al (2009) quienes, en 20 muestras analizadas, encuentran que el número varía entre 2 y 13; nuestros valores también se ajustan a lo reportado por Marx et al (2010b), quienes encuentran entre 6 y 12 fascículos. En nuestro estudio observamos para NRS un área total de 5,6 mm 2 y un área fascicular total de 1,1808 mm 2 ; por su parte, los valores que señalan Marx et al (2010b) son de 3,6 mm 2 y de 1,12 mm 2 respectivamente.…”