A study of the posterior interosseous nerve (PIN) and the radial tunnel in 30 Thai cadavers

Prasartritha, Thavat; Liupolvanish, Prasert; Rojanakit, Anutast

doi:10.1016/0363-5023(93)90253-y

Cited by 87 publications

(66 citation statements)

References 26 publications

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“…Various research studies have proposed that the nerve is exposed along the nerve course from where the deep branch of radial nerve leaves out of the supinator to the proximal end of supinator. Afterward, protection for the deep branch of radial nerve under direct vision is provided to avoid injury on the deep branch of radial nerve (Thompson, 1918;Spinner, 1978;Prasartritha et al, 1993;Urch et al, 2015). However, most surgeons do not deliberately expose the deep branch of the radial nerve in the supinator.…”

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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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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“…Figure 1 shows Posterior Interosseous Nerve Syndrome the anatomical distances and their measurement points as described previously. 14) The proximal arcade of the superficial layer of the supinator muscle (arcade of Frohse) and the distal border of the supinator muscle were studied as structures that may cause compression of the posterior interosseous nerve. The arcade of Frohse was observed under a stereomicroscope (Stemi 2000; Carl Zeiss, Jena, Germany) and classified as tendinous if the medial and lateral halves of the arch were fibrous in texture and white in color, or membranous if the medial half of the arcade was muscular or translucent.…”

Section: Methodsmentioning

confidence: 99%

“…6) Patients with posterior interosseous nerve syndrome present with weakness in finger extension and thumb extension and abduction. 4,7,20) Posterior interosseous nerve syndrome has been described in several populations, [2][3][4]14,15,17) but only one anatomic study has considered the posterior interosseous nerve syndrome in the Turkish population, in which the texture of the arcade of Frohse was fibrous in 80% and was membranous in 20% of cadavers. 13) In addition, the innervation of the extensor carpi radialis brevis muscle is unclear.…”

Section: Introductionmentioning

confidence: 99%

Investigation of Two Possible Compression Sites of the Deep Branch of the Radial Nerve and Nerve Supply of the Extensor Carpi Radialis Brevis Muscle

Kırıcı

Irmak

2004

Neurol. Med. Chir.(Tokyo)

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The posterior interosseous nerve arises from the deep branch of the radial nerve, and compression by adjacent structures results in posterior interosseous nerve syndrome. Sixty upper limbs from 30 Turkish subjects (18 males and 12 females) were dissected to reveal the course of the posterior interosseous nerve and to examine possible compression sites at the proximal and distal edges of the supinator muscle, and the exit of the nerve from the extensor carpi radialis brevis muscle. Posterior interosseous nerve syndrome is most probably caused by the tendinous part of the supinator muscle at the proximal edge.

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“…After the point of bifurcation of the radial nerve, the posterior interosseous nerve (PIN) travels through the radial tunnel (Loh et al, 2004). Prasartritha et al (1993) dissected sixty fresh cadaveric upper extremities and suggested the course of the radial nerve in the radial tunnel, an area that varies but begins in the furrow between the brachioradialis and brachialis in the distal arm and ends at the distal edge of the supinator muscle in the proximal forearm. Ferdinand et al (2006) concluded that the most common MRI (magnetic resonance imaging) finding in radial tunnel syndrome are muscle denervation edema or atrophy along the distribution of the PIN.…”

Section: Introductionmentioning

confidence: 99%

Multiple Variations of Extensor Muscles of Forearm in Relation to the Radial Nerve: a Case Report and Review

et al. 2008

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SUMMARY:During routine dissection in the Department of Anatomy, multiple variations of forearm muscles in relation to the radial nerve and its branches were observed on the right side of a 34 year old male cadaver. Brachioradialis close to its origin was receiving muscle fibers from the brachialis and the radial nerve was passing in between them. Extensor carpi radialis brevis was absent and the extensor carpi radialis longus was giving two tendons in the second compartment of extensor retinaculum before its insertion while passing deep to the abductor pollicis longus. Absence of extensor carpi radialis brevis can be explained with the arrangement in lower mammals, where the two extensores carpi radiales are represented by one muscle. Ontogeny repeats phylogeny and anatomical variations have developmental basis. Hence, the pattern of muscular arrangement in this case can be said to be less evolved than the usual arrangement. The course of radial nerve between the two heads of brachioradialis makes it highly vulnerable to compression and injury, which may manifest as wrist drop (radial nerve palsy) or radial tunnel syndrome (compression of posterior interosseous nerve).

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A study of the posterior interosseous nerve (PIN) and the radial tunnel in 30 Thai cadavers

Cited by 87 publications

References 26 publications

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

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

Investigation of Two Possible Compression Sites of the Deep Branch of the Radial Nerve and Nerve Supply of the Extensor Carpi Radialis Brevis Muscle

Multiple Variations of Extensor Muscles of Forearm in Relation to the Radial Nerve: a Case Report and Review

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