The position of the upper limb during shoulder arthroscopy does not affect the distance between axillary nerve and glenoid

Matter-Parrat, Valérie; Amiri, Laela El; Koch, Guillaume; Duparc, Fabrice; Clavert, P

doi:10.1007/s00276-020-02491-x

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…Although this position was challenging to simulate in a few cases due to the rigidity caused by the embalming process, in cases where visibility or access was severely limited, only non-essential muscles in close relation to the target neurovascular structures were transected or reflected. A recent study by Matter-Parrat et al [ 16 ] investigated whether there is a change in the position of the axillary nerve in relation to the glenoid rim when a patient is positioned in either a lateral decubitus or a beach chair position and the authors found that altering the position of the arm did not influence the position of the nerve in relation to the glenoid rim, so it is safe to assume that the nerve remains relatively consistent along its course when arm position is altered within a surgical position.…”

Section: Methodsmentioning

confidence: 99%

The surgical anatomy of the axillary approach for nerve transfer procedures targeting the axillary nerve

Beytell,

Mennen,

van Schoor

et al. 2023

Surg Radiol Anat

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Purpose The exact relational anatomy for the anterior axillary approach, targeting the axillary nerve for nerve transfers/grafts, has not been fully investigated. Therefore, this study aimed to dissect and document the gross anatomy surrounding this approach, specifically regarding the axillary nerve and its branches. Methods Fifty-one formalin-fixed cadavers (98 axilla) were bilaterally dissected simulating the axillary approach. Measurements were taken to quantify distances between identifiable anatomical landmarks and relevant neurovascular structures encountered during this approach. The musculo-arterial triangle, described by Bertelli et al., to aid in identification on localization of the axillary nerve, was also assessed. Results From the origin of the axillary nerve till (1) latissimus dorsi was 62.3 ± 10.7 mm and till (2) its division into anterior and posterior branches was 38.8 ± 9.6 mm. The origin of the teres minor branch along the posterior division of the axillary nerve was recorded as 6.4 ± 2.9 mm in females and 7.4 ± 2.8 mm in males. The musculo-arterial triangle reliably identified the axillary nerve in only 60.2% of the sample. Conclusion The results clearly demonstrate that the axillary nerve and its divisions can be easily identified with this approach. The proximal axillary nerve, however, was situated deep and therefore challenging to expose. The musculo-arterial triangle was relatively successful in localising the axillary nerve, however, more consistent landmarks such as the latissimus dorsi, subscapularis, and quadrangular space have been suggested. The axillary approach may serve as a reliable and safe method to reach the axillary nerve and its divisions, allowing for adequate exposure when considering a nerve transfer or graft.

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Section: Methodsmentioning

confidence: 99%