Musculocutaneous nerve entrapment revisited

Davidson, James J.; Bassett, Frank H.; Nunley, James A.

doi:10.1016/s1058-2746(98)90053-2

Cited by 54 publications

(26 citation statements)

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“…Non-traumatic cases were attributed to irritation of the nerve from vigorous activity where it was fixed by the fascia and compressed by the lateral edge of the biceps tendon, especially in positions of combined pronation and extension. [3][4][5][6][7]12 Our surgical findings confirmed this view.…”

Section: Discussionsupporting

confidence: 72%

“…Compression of the lateral antebrachial cutaneous nerve (LACN) at the elbow, first described by Narasanagi of surgical treatment for compression of the LACN at the elbow have been described; 1,[3][4][5][6][7] two additional cases in which operation was required have been attributed to direct injury to the LACN at the elbow during phlebotomy 9 and to compression from a glomus tumour. 10 We report the surgical treatment of eight new cases of compression of the LACN at the elbow, carried out by the same author (DLV).…”

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confidence: 99%

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Surgical treatment of compression of the lateral antebrachial cutaneous nerve

Dailiana

Roulot

Viet

2000

The Journal of Bone and Joint Surgery. British volume

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We describe an operation to relieve compression of the lateral antebrachial cutaneous nerve at the elbow. Between 1987 and 1997 we operated on seven patients, one with bilateral compression. In two the compression was associated with injury to biceps. A longitudinal or a transverse incision was carried out and the nerve was released from the deep fascia. Partial excision of the biceps aponeurosis was undertaken in the patients who did not have injury to biceps; some additional procedures were required for those patients with injuries. All patients had symptomatic relief.

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Section: Discussionsupporting

confidence: 72%

mentioning

confidence: 99%

Surgical treatment of compression of the lateral antebrachial cutaneous nerve

Dailiana

Roulot

Viet

2000

The Journal of Bone and Joint Surgery. British volume

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“…The arrangement of the fibroadipose tissue sheaths may be compared to a ''telescope'', and may allow compliance between variations of length of CB and the constant course of the MCN. It may explain the low frequency of entrapment syndrome of MCN, which originates in physical activity or violent passive movements of the arm and forearm (Davidson et al, 1998;Swain, 1995).…”

Section: Discussionmentioning

confidence: 99%

Musculocutaneous nerve: Histotopographic study and clinical implications

et al. 2006

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Surgical reconstruction of severe brachial plexus injuries includes nerve grafting and neurotization techniques of the musculocutaneous nerve (MCN) to recover elbow flexion. In treating recurrent anterior shoulder instability, knowledge of the topography of the MCN is important for the margin of safety available during dissection. The present study evaluates the origin and course of the MCN and its branches, and their relationships to bone landmarks. Twelve unembalmed cadavers (50-82 years old) were dissected. A histological study of the MCN and the coracobrachialis muscle (CB) was also carried out. The mean distance (+/-SD) of the MCN from the coracoid process to the origin, points of entry to, and exit from the CB were 2.9 +/- 0.5 cm, 7.7 +/- 2.5 cm, and 11.6 +/- 0.8 cm, respectively. The first two findings were also validated during surgical approaches to the shoulder in 59 subjects. The mean distance of the MCN from the acromion to the origin, points of entry to, and exit from the CB were 6.4 +/- 0.3 cm, 7.7 +/- 0.8 cm, and 10.4 +/- 1.9 cm, respectively. The mean length of the MCN from its origin to the points of entry to and exit from the CB were 6.7 +/- 1.6 cm and 11.0 +/- 1.0 cm, respectively. The mean length of the MCN inside the muscle was 4.4 +/- 1.9 cm. The distance from the coracoid process to the point of entry to the CB and the length of the MCN inside the muscle were inversely related (P < 0.05). The distance from the coracoid process to the point of exit of the MCN was positively correlated with the length of the nerve within the CB (P < 0.05). Histology showed that, during the intramuscular course of the MCN, the epineurium is composed of 4-5 concentrically arranged lamina of connective tissue which shows different dispositions along the circumference of the nerve trunk. On the ventral and dorsal aspects of the nerve the lamina are closely packed, but on the medial and lateral sides they are separated by thin layers of adipose tissue. This uneven disposition of the adipose tissue gives the epineurium an oval profile in transverse section (mean circular factor 0.8). The arrangement of the fibroadipose tissue sheaths may be compared to a "telescope" and may allow compliance between variations of length of CB and the constant course of the MCN. Clinically, a decrease in this "sliding system" may expose the nerve to mechanical effects of muscle contraction, with the possibility of a compression syndrome.

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“…Initially, conservative management is recommended. If conservative management fails, surgical decompression can be employed (3,11). Some patients respond to resting the arm and to curtailing the physical activities of the upper extremity; most would require an external device to fully rest the arm such as a posterior splint.…”

Section: DI Is Sc Cu Us Ss Si Io On Nmentioning

confidence: 99%

A Soldier with Lateral Antebrachial Cutaneous Neuropathy: Malingering or Fact?

Yıldız¹,

Kılınç²,

Ardıç³

2010

tftr

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Ö Öz ze et t G Gi ir ri ifl fl: : Lateral antebrakial kutanöz sinir (LAKS) kompresyonu nadiren akla gelen ancak aç›kl›kla tan›mlanabilen bir sendromdur. Bu sendrom, hasta rolü yaparak askeri görevlerinden kaç›nabilecek askerlerde ay›r›c› tan›da göz önünde bulundurulmal›d›r. Bu vakada dirsek ekstansiyonunun ortaya ç›kard›¤› sa¤ önkola yay›lan yan›c› a¤r› nedeniyle dirsek ekstansiyonundan kaç›nma flikayeti ile baflvuran 23 yafl›nda bir askeri tan›mlad›k. LAKS nöropatisi, askeri bir kampta avuç karfl›ya bakarken kendini yukar› çek-meyi içeren fiziksel aktivite ile ortaya ç›km›fl ve ilk önce temaruz oldu¤u düflünülmüfl daha sonra klinik ve elektrodiagnostik bulgularla tan›s› konulmufltur. Askerlik görevi s›ras›nda temaruz ile suçlanan kifliler, askeri e¤itimleri ile iliflkili periferal nörolojik ve kas iskelet sistemi yaralanmalar› aç›s›ndan da dikkatli bir flekilde incelenmelidir. Özellikle ön kol a¤r›s› flikayeti olan ve bu nedenle dirsek ekstansiyonu yapamayan hastalar›n ay›r›c› tan›s›nda LAKS nöropatisi ak›lda tutulmal› ve elektrofizyolojik incelemelerle do¤rulanmal›d›r. Türk Fiz T›p Rehab Derg 2010;56:145-7. A An na ah ht ta ar r K Ke el li im me el le er r: : Lateral antebrakial kutanöz sinir, nöropati, temaruz S Su um mm ma ar ry y I In nt tr ro od du uc ct ti io on n: : Compression of the lateral antebrachial cutaneous nerve (LACN) is a rarely recognized but clearly definable syndrome. It should be taken into account in the differential diagnosis in the context of soldiers who are suspected of avoiding military duties by assuming the sick role. In this report, we describe a 23-year-old soldier who presented with avoidance of elbow extension due to a burning pain in the right forearm induced by extension. LACN neuropathy, which occurred after physical training including palm-away pull ups in the military camp and was initially suspected to be malingering, was later diagnosed according to the clinical and electrodiagnostic findings. People who are accused of malingering in military settings should be examined carefully also concerning the training-related injuries of the peripheral nervous and musculoskeletal systems. Especially for patients complaining of forearm pain that leads to inability to extend the elbow, LACN neuropathy should be considered in the differential diagnosis and confirmed by electrophysiological examination. Turk J Phys Med Rehab 2010;56:145-7. K Ke ey y W Wo or rd ds s: : Lateral antebrachial cutaneous nerve, neuropathy, malingering

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Musculocutaneous nerve entrapment revisited

Cited by 54 publications

References 4 publications

Surgical treatment of compression of the lateral antebrachial cutaneous nerve

Surgical treatment of compression of the lateral antebrachial cutaneous nerve

Musculocutaneous nerve: Histotopographic study and clinical implications

A Soldier with Lateral Antebrachial Cutaneous Neuropathy: Malingering or Fact?

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