Surgical anatomy of the radial nerve in the arm: a cadaver study

Sapage, Rita; Pereira, Pedro; Vital, Luísa; Madeira, M. Dulce; Pinho, André

doi:10.1007/s00590-021-02916-2

Cited by 11 publications

(9 citation statements)

References 12 publications

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“…Several studies have evaluated the anatomical location of the radial nerve in relation to different landmarks such as the olecranon process, lateral epicondyle, medial epicondyle, intermuscular septum and/or acromial process [ 8 , 29 – 31 ]. The study of Suwannaphisit et al found that the radial nerve passed the posterior humerus from 130.00 ± 2.07 mm between the upper olecranon and the center of the radial nerve to 122.00 ± 2.33 mm between the lateral epicondyle and the lateral intermuscular septum [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

The risk of iatrogenic radial nerve and/or profunda brachii artery injury in anterolateral humeral plating using a 4.5 mm narrow DCP: A cadaveric study

et al. 2021

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Introduction Fixation of humeral shaft fractures with a plate and screws can endanger the neurovascular structure if proper care is not taken. No studies to our knowledge have studied the risk of iatrogenic radial nerve and/or profunda brachii artery (RNPBA) injury from each screw hole of a 4.5 mm narrow dynamic compression plate (narrow DCP). The purpose of this study is to evaluate the risk of RNPBA injury in anterolateral humeral plating with a 4.5 mm narrow DCP. Material and methods 18 humeri of 9 fresh-frozen cadavers in the supine position were exposed via the anterolateral approach with 45 degrees of arm abduction. A hypothetical fracture line was marked at the midpoint of each humerus. A precontoured ten-hole 4.5mm narrow DCP was applied to the anterolateral surface of the humerus using the fracture line to position the center of the plate. All screw holes were drilled and screws inserted. The cadaver was then turned over to the prone position with 45 degrees of arm abduction, and the RNPBA exposed. The holes through in which 100% of the screw had contact with or penetrated the RNPBA were identified as dangerous screw holes, while lesser percentages of contact were defined as risky. Results The relative distance ratios of the entire humeral length from the lateral epicondyle of the humerus to the 4th, 3rd, 2nd and 1st proximal holes were 0.64, 0.60, 0.56 and 0.52, respectively. The most dangerous screw hole was the 2nd proximal, in which all 18 screws had contacted or penetrated the nerve, followed by the risky 1st (12/18), 3rd (8/18) and 4th (2/18) holes. Conclusion In humeral shaft plating with the 4.5mm narrow DCP using the anterolateral approach, the 2nd proximal screw hole carries the highest risk of iatrogenic radial nerve and/or profunda brachii artery injury.

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Section: Discussionmentioning

confidence: 99%

The risk of iatrogenic radial nerve and/or profunda brachii artery injury in anterolateral humeral plating using a 4.5 mm narrow DCP: A cadaveric study

et al. 2021

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“…At the level of the lateral epicondyle, it divides into superficial and deep branches. 52 Depending on the location of the RN on the humerus or the spot where it pierces the intermuscular septum, it may be at risk during operative procedures of the humerus (e.g., in fixation of a humerus fracture). 53 At the level of the elbow, the RN usually divides into a superficial branch (SB) and a deep branch.…”

Section: Radial Nervementioning

confidence: 99%

Anatomical Variants of the Upper Limb Nerves: Clinical and Preoperative Relevance

Schwabl

Hörmann

Strolz

et al. 2023

Semin Musculoskelet Radiol

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Profound knowledge of nerve variations is essential for clinical practice. It is crucial for interpreting the large variability of a patient's clinical presentation and the different mechanisms of nerve injury. Awareness of nerve variations facilitates surgical safety and efficacy. Clinically significant anatomical variations can be classified into two main groups: variability in the course of the nerve and variability of structures surrounding the nerve. In this review article we focus on the most common nerve variants of the upper extremity and their clinical relevance.

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“…Traumatic radial nerve injury (RNI) is most frequently caused by fractures, either directly by the fracture itself (primary RNI) or iatrogenically during fracture treatment (secondary RNI). [1][2][3] The overall prognosis of RNI after fractures or fracture treatment is good, justifying a relatively expectant approach; for example, in the setting of humeral shaft factures, 77% to 94% of patients recover spontaneously, with a mean recovery onset of 8 weeks after the nerve injury (range, 3 to 30 weeks). [4][5][6] However, success rates of nerve reconstruction decline with delay.…”

Section: Introductionmentioning

confidence: 99%

Optimal timing of needle electromyography to diagnose lesion severity in traumatic radial nerve injury

et al. 2023

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Surgical anatomy of the radial nerve in the arm: a cadaver study

Cited by 11 publications

References 12 publications

The risk of iatrogenic radial nerve and/or profunda brachii artery injury in anterolateral humeral plating using a 4.5 mm narrow DCP: A cadaveric study

The risk of iatrogenic radial nerve and/or profunda brachii artery injury in anterolateral humeral plating using a 4.5 mm narrow DCP: A cadaveric study

Anatomical Variants of the Upper Limb Nerves: Clinical and Preoperative Relevance

Optimal timing of needle electromyography to diagnose lesion severity in traumatic radial nerve injury

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