Relationship of the Median and Radial Nerves at the Elbow: Application to Avoiding Injury During Venipuncture or Other Invasive Procedures of the Cubital Fossa

Abstract

IntroductionThe median and radial nerves are two important neural structures found in the cubital fossa. The trajectory and landmarks used to identify their location are important when procedures are done in this area.Methods and materialsTen fresh-frozen cadavers were dissected (20 upper limbs) and measurements were taken from the medial epicondyle to the median and radial nerves as well as to the lateral epicondyle of each limb.ResultsThe distance between the medial epicondyle and the median nerve was found to be three centimeters with a range of 2.1 to four centimeters and the distance from the medial epicondyle to the radial nerve had a mean distance of 5.5 cm and a range of 3.8 to seven centimeters.DiscussionDamage to the median or radial nerves can lead to major complications including loss of extension, flexion, and sensation in the forearm and hand. Other studies have tried to identify the course of these nerves in order to prevent their injury during procedures.ConclusionAfter identifying the medial epicondyle, using the results we obtained, physicians may have a better understanding of where the median and radial nerves lie within the cubital fossa when performing procedures in this area.

Imaging of Anatomical Variants Around the Elbow

“…It is located medially to the brachial artery and deeply to the biceps tendon aponeurosis at the cubital fossa of the elbow. 31 When it enters the forearm, it passes between the heads of the pronator teres. 10 Husarik et al reported that the MN courses between the pronator teres muscle and the brachialis muscle, close to the vascular bundle in 83% of asymptomatic volunteers.…”

Pseudo-Anterior Interosseus Nerve Syndrome: A Case Report and a Review of Clinical Signs, Pathology and Functional Anatomy of the Precision Grip

“…This technique allows excellent visual access to the joints and facets of the elbow. However, the neurovascular bundles traversing the elbow joint can be relatively easy prey to the instruments of the surgeon and detailed knowledge of the anatomy of the region is essential [ 15 , 16 ]. Nevertheless, injuries to the nerves traversing the elbow are surprisingly rare.…”

Absence of Median Nerve in Cubital Fossa - A Rare Anatomical Variation

“…MN is an important neural structure in the CF which has to be identified during surgical procedures in order to avoid injuries. 3 Injury to the MN can lead to loss of flexion of hand. Various studies have been done to study the course and variation in the MN.…”