The Terminal Branch of Posterior Interosseous Nerve: A Useful Donor for Digital Nerve Grafting

Reissis, N.; Stirrat, A. N.; Manek, Sanjiv; Dunkerton, M. C.

doi:10.1016/0266-7681(92)90190-d

Cited by 12 publications

(9 citation statements)

References 8 publications

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“…Elgafy et al stated that "In contrast to the study conducted by Reissis et al, the current study showed that the last muscular branch from the lateral subbranch was to the extensor pollicis longus rather than the extensor indicis, which was supplied by a branch from the medial subbranch." 6,7 The PIN has been investigated for use as a nerve graft by Reissis et al 8 The mean distance ($50 mm) between the DRUJ and the last motor branch of the PIN observed in this study confirm the approximate length of the PIN available for harvesting for nerve grafting. Waters and Schwartz reported that the range of the obtainable length of the nerve was 5 to 10 cm.…”

Section: Discussionsupporting

confidence: 74%

“…The present study proposes that the most proximal part of the ulnar head can be used as an anatomical landmark for procedures and denervation surgery at the wrist. Anatomical landmarks, such as the lateral epicondyle of the humerus or the lateral border of the supinator, 8 have been used to define a reference point for the PIN. However, for hand surgeons the lateral epicondyle, or any proximal forearm landmark, is less desirable, as it is usually outside the surgical field.…”

Section: Discussionmentioning

confidence: 99%

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Important Anatomical Relationships of the Posterior Interosseous Nerve in the Distal Forearm for Surgical Planning: A Cadaveric Study

et al. 2014

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A thorough knowledge of the anatomy of the terminal branch of the posterior interosseous nerve (PIN) and its relationship to the anterior interosseous nerve (AIN) is essential in facilitating regional anesthetic blocks as well as in planning surgical exposures for wrist surgery. Division of the PIN has been recommended in patients with persistent wrist pain who have not responded to conservative treatment and whose physical demands are low. 1 Denervation of the PIN is undertaken as an adjunct to salvage procedures for arthritis of the wrist, such as four-corner fusion and proximal row carpectomy. In addition, the last motor branch of the PIN has been a source of nerve grafts.The wrist joint capsule is supplied by the terminal branches of the AIN, PIN, lateral cutaneous nerve of the forearm, median nerve, and dorsal branch of the ulnar nerve. Total wrist denervation may provide pain relief, but multiple incisions and the possible loss of proprioception are potential problems. 2-5 Partial denervation of the terminal branches of the AIN and PIN can be achieved with a single incision on the dorsum of the wrist. 2 The current study focuses on the terminal branches of the PIN, particularly in the forearm, and analyzes the consistency of its anatomic location, its dimensions, its last motor branch, and its relationship to the most proximal part of ulnar head and the AIN, as these parameters may have clinical relevance for diagnostic and therapeutic procedures in and around the wrist. MethodsThirty embalmed forearms, 15 right and 15 left, 18 males and 12 females, with a mean age of 81 (range 37 to 96 years) were dissected. Demographic data were obtained from the records maintained in the anatomy department. These selected Keywords ► cadaveric wirst study ► terminal posterior interosseous nerve ► denervation wrist surgery AbstractA thorough knowledge of the anatomy of the terminal branch of the posterior interosseous nerve (PIN) and its relationship to the anterior interosseous nerve (AIN) is essential in facilitating regional anesthetic blocks and planning surgical exposures for wrist surgery and arthrodesis of wrist and proximal row carpectomy. This cadaveric study focused on the anatomy and course of the PIN and its anatomical relationships at the distal forearm. Thirty embalmed cadaver forearms were dissected using microsurgical techniques. A structured pro forma was used to collect data. The PIN was consistently found in the fourth extensor compartment in all specimens. The last motor branch was given off 46.9 AE 8.4 mm (mean AE standard deviation) from the most proximal part of the ulnar head. The AIN was found lying consistently on the anterior aspect of the interosseous membrane, being on average 2.8 AE 0.2 mm (mean AE standard deviation) from the PIN. This knowledge will facilitate the planning of diagnostic and therapeutic procedures associated with the wrist.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Important Anatomical Relationships of the Posterior Interosseous Nerve in the Distal Forearm for Surgical Planning: A Cadaveric Study

et al. 2014

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“…Moreover, the PIN is an expendable nerve at the wrist level and has been used as a source of nerve graft. 22 Alternative to our transfer would be to connect the lateral antebrachial cutaneous nerve to the dorsal branch of the ulnar nerve, although this has a drawback of requiring a long nerve graft. 23 In a motor branch, more than half of the myelinated fibers are sensory in function.…”

Section: Discussionmentioning

confidence: 99%

Transfer of the Radial Nerve Branch to the Extensor Carpi Radialis Brevis to the Anterior Interosseous Nerve to Reconstruct Thumb and Finger Flexion

Bertelli

2015

The Journal of Hand Surgery

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“…Many publications have shown similarities in the size [3] [6] [8] [21] and in the nerve density [17] of the PIN compared to digital nerves. However, to the knowledge of the authors, this is the first study that describes the anatomical structure of the PIN, taking into account the relationship between the size and number of individual fascicles to the size of the whole nerve.…”

Section: Discussionmentioning

confidence: 99%

The terminal branch of the posterior interosseous nerve: an anatomic and histologic study

Bonczar

Walocha

Bonczar³

et al. 2021

Folia Morphol

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Background: The aim of this study was to evaluate the terminal branch of the posterior interosseous nerve (PIN) by anatomically and histologically assessing the number, dimension, and area of its individual fascicles, by determining the dimension and area of the whole nerve itself, and by calculating the nerve density ratio (ratio of the sum of the areas of individual fascicles to the area of the whole nerve) of the terminal branch of the PIN. Methods: Twenty-eight terminal branches of the PIN nerve samples were collected from patients undergoing partial denervation of the wrist. The nerve samples were fixed in 10% buffered formalin and stained with hematoxylin and eosin to visualize their nerve bundles. Quantitative analysis of individual fascicles and the whole nerve itself were carried out. Results: Ten nerve samples (35,7%) had one single fascicle (group 1) while the remaining 18 nerve samples (64,3%) contained 2-9 fascicles (group 2). The difference in the sum of the areas of individual fascicles between the two groups did not constitute a statistical difference. Statistically significant differences (p <0.05) were seen between area of whole nerve, percentage of fascicles to the nerve surface and the cross-section maximum nerve length and width. Conclusions: The number of nerve fascicles in the terminal branch of the PIN does not affect the overall size of the nerve. The majority of the volume of multi-fascicle nerves, therefore, primarily consists of the internal perineurium. However, due to the low number of nerves, this 2 question cannot be clearly answered. This sets a further direction for further research on a larger group.

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The Terminal Branch of Posterior Interosseous Nerve: A Useful Donor for Digital Nerve Grafting

Cited by 12 publications

References 8 publications

Important Anatomical Relationships of the Posterior Interosseous Nerve in the Distal Forearm for Surgical Planning: A Cadaveric Study

Important Anatomical Relationships of the Posterior Interosseous Nerve in the Distal Forearm for Surgical Planning: A Cadaveric Study

Transfer of the Radial Nerve Branch to the Extensor Carpi Radialis Brevis to the Anterior Interosseous Nerve to Reconstruct Thumb and Finger Flexion

The terminal branch of the posterior interosseous nerve: an anatomic and histologic study

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