Vulnerability of the Posterior Interosseous Nerve During Proximal Radius Exposures

Mekhail, Anis O.; Ebraheim, Nabil A.; Jackson, William T.; Yeasting, Richard A.

doi:10.1097/00003086-199506000-00021

Cited by 27 publications

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“…However, quantitative descriptions of the motion of the nerve accompanying forearm rotation have yielded conflicting results, with some substantiating the importance of pronation and others failing to demonstrate its utility. 2,3,[9][10][11]13,14,17,18,21 Several possible mechanisms can be postulated for the protection of the nerve by pronation of the forearm. The PIN might be displaced in a proximal/distal or radial/ulnar direction from the operative area by forearm rotation.…”

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confidence: 99%

“…2,3,[8][9][10][11]13,14,17,18,21 It has often been reported that pronation displaces the PIN from the operative field in this circumstance 2,3,[8][9][10][11]13,14,17,18,21 (Figure 2). However, quantitative descriptions of the motion of the nerve accompanying forearm rotation have yielded conflicting results, with some substantiating the importance of pronation and others failing to demonstrate its utility.…”

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confidence: 99%

“…In contrast to some previous studies, this dissection did not disturb the in situ location of the PIN, and, therefore, it more accurately reproduces the clinical application of the Kocher approach to the lateral elbow and proximal radius, where the supinator is not dissected off of the proximal radius. 1,4,5,8,10,11,[13][14][15]17,21 …”

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Anatomic considerations regarding the posterior interosseous nerve at the elbow

Lawton

Cameron-Donaldson

Blazar

et al. 2007

Journal of Shoulder and Elbow Surgery

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confidence: 99%

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confidence: 99%

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Anatomic considerations regarding the posterior interosseous nerve at the elbow

Lawton

Cameron-Donaldson

Blazar

et al. 2007

Journal of Shoulder and Elbow Surgery

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“…Elbow pain is one of the most frequent presenting symptoms but was not noted in this case. Lipomas are the most common cause of PIN palsy, [5][6][7][8][9] the second most commonest being iatrogenic or post-traumatic [2,3,6,8,[10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Tardy Posterior Interosseous Palsy

Sb¹,

Ferguson²,

S³

2017

J Clin Case Rep

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“…As the interior approaches the dissection line of the supinator, the extent allowed for the supinator to be dissected increases in length. According to examples in literature, the risk involved in the dissection of the supinator is reduced because of the shift of the deep branch of radial nerve toward the ulnar side when the forearm is pronating; however, the quantitative observation results on the radius shift when the forearm is pronating are inconsistent (Kocher, 1911;Kaplan, 1941;Davies & Laird, 1948;Capener, 1966;Strachan & Ellis, 1971;Mekhail et al, 1995;Mekhail et al, 1996;Strauch et al, 1996). Moreover, the operability is low when surgeries are performed.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Factors/Countermeasures in/against Iatrogenic Injury of the Deep Branch of Radial Nerve in the Thompson Approach Via Middle and Proximal Segments of Forearm

et al. 2017

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SHAN, J.; WANG, C.; REN, D. & JIANG, H.Anatomical factors/countermeasures in/against iatrogenic injury of the deep branch of radial nerve in the Thompson approach via middle and proximal degments of forearm. Int. J. Morphol., 35(1):92-98, 2017. SUMMARY:This study aimed to investigate the anatomical factors affecting iatrogenic injury of the deep branch of radial nerve during the Thompson approach and to propose corresponding countermeasures. Thompson approach was used to measure the horizontal/ longitudinal distance from the position where the deep branch of radial nerve leaves the supinator to the ulnar margin of extensor carpi radialis brevis/humeroradial joint line. Measurements were obtained by using 48 adult cadaver specimens, which were used in teaching. We observed the lentor situation of the extensor digitorum and extensor carpi radialis brevis in proximal forearm segments and measured the distance from the deep branch of radial nerve to the humeroradial joint line at the lateral side of the radius in the neutral position of forearm rotation. The horizontal distance from the point where the deep branch of radial nerve leaves the inferior margin of supinator to the ulnar margin of extensor carpi radialis brevis was 1.3 ± 0.3 cm. The distance to the humeroradial joint line was 61.3 ± 17.6 mm. The distance to the lentor extent of extensor digitorum and extensor carpi radialis brevis at the distal part of humeroradial joint was 7.1 ± 2.1 cm. The distance from the deep branch of radial nerve to the humeroradial joint line at the lateral side of the radius is 3.2 ± 0.6 mm. Anatomical factors are observed in iatrogenic injury of the deep branch of radial nerve during the Thompson approach. Stretching the extensor digitorum before the dissection of the supinator is hazardous.

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Vulnerability of the Posterior Interosseous Nerve During Proximal Radius Exposures

Cited by 27 publications

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Anatomic considerations regarding the posterior interosseous nerve at the elbow

Anatomic considerations regarding the posterior interosseous nerve at the elbow

Bilateral Tardy Posterior Interosseous Palsy

Anatomical Factors/Countermeasures in/against Iatrogenic Injury of the Deep Branch of Radial Nerve in the Thompson Approach Via Middle and Proximal Segments of Forearm

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