No abstract

We attempted to determine the relationship between the cephalic vein and the sensory branch of the radial nerve at the wrist to help prevent lesions of the radial nerve when the cephalic vein is cannulated. We examined the anatomy of 33 postmortem specimens and suggest that puncture of the cephalic vein 12 cm or more proximal to the styloid process can prevent radial nerve lesions.

The pregnancy was uneventful in all cases. The fetal presentation was cephalic in three cases, a breech presentation in four cases, a face presentation in two cases. The lesion involved the cervical spine in six cases. Three patients presenting upper cervical injuries died before the age of 6 years. The six remaining patients experienced no neurological improvement. These rare conditions occur during difficult deliveries with abnormal presentations, the most common being a breech presentation with entrapment of the fetal head. In a child with hypotonia, flaccid quadriplegia or high thoracic paraplegia after a difficult delivery, a spinal cord injury must be suspected and plain radiographs and magnetic resonance imaging (MRI) must be performed.