Skip to main content
Erschienen in: Surgical and Radiologic Anatomy 9/2010

01.11.2010 | Original Article

Distribution of sympathetic fiber areas of radial nerve in the forearm: an immunohistochemical study in cadavers

verfasst von: S. Chakravarthy Marx, Pramod Kumar, S. Dhalapathy, C. Anitha Marx, A. S. D’Souza

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 9/2010

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Secondary to peripheral nerve injuries, involvement of sympathetic fibers complications such as complex regional pain syndrome (CRPS) have been reported. There are limited studies on the sympathetic fibers and their distribution in the upper limb nerves. There are no reports available in the distribution of the sympathetic fibers/areas of radial nerve in the forearm. The aim of the present study was an attempt to find the distribution of sympathetic fibers in the radial nerve just above cubital fossa (RN), superficial branch of radial nerve at cubital fossa (SBRN-1) and above wrist (SBRN-2).

Methods

We have studied on 19 fresh human cadaveric RN, SBRN-1, and SBRN-2 samples. Frozen sections of these nerves were processed by immunohistochemical (tyrosine hydroxylase) method for sympathetic fibers.

Results

The sympathetic fibers area (Asym) was found to be more in RN when compared to SBRN-1 and SBRN-2. The comparison of the sympathetic index (SI = sympathetic fibers area/total fascicular area of the nerve) between RN and SBRN-1 (p < 0.001), RN and SBRN-2 (p < 0.001), and SBRN-1 and SBRN-2 (p = 0.016) were statistically significant. The sympathetic index (SI) for SBRN-1 was more when compared to RN and SBRN-2.

Conclusions

Sympathetic fibers area (Asym) was found to be more in RN when compared to SBRN-1 and SBRN-2. The sympathetic ratio (SI) and percentage of sympathetic fibers area (Asym %) was more in SBRN-1 when compared to RN and SBRN-2. These results of the study might help to explain sympathetic system-related diseases in the area of distribution of RN and SBRN.
Literatur
1.
Zurück zum Zitat Balogh B, Valencak J, Vesely M, Flammer M, Gruber H, Piza-Katzer H (1999) The nerve of Henle: an anatomic and immunohistochemical study. J Hand Surg Am 24:1103–1108CrossRefPubMed Balogh B, Valencak J, Vesely M, Flammer M, Gruber H, Piza-Katzer H (1999) The nerve of Henle: an anatomic and immunohistochemical study. J Hand Surg Am 24:1103–1108CrossRefPubMed
2.
Zurück zum Zitat Balogh B, Auterith A, Behrus R, Maier S, Vesely M, Piza-Katzer H (2002) The sympathetic axons of the nerves of the hand. Handchir Mikrochir Plast Chir 34:369–373CrossRefPubMed Balogh B, Auterith A, Behrus R, Maier S, Vesely M, Piza-Katzer H (2002) The sympathetic axons of the nerves of the hand. Handchir Mikrochir Plast Chir 34:369–373CrossRefPubMed
3.
Zurück zum Zitat Baron R, Levine JD, Fields HL (1999) Causalgia and reflex sympathetic dystrophy: does the sympathetic nervous system contribute to the generation of pain? Muscle Nerve 22:678–695CrossRefPubMed Baron R, Levine JD, Fields HL (1999) Causalgia and reflex sympathetic dystrophy: does the sympathetic nervous system contribute to the generation of pain? Muscle Nerve 22:678–695CrossRefPubMed
4.
Zurück zum Zitat Campero M, Serra J, Ochoa L (2005) Peripheral projections of sensory fascicles in the human superficial radial nerve. Brain 128:892–895CrossRefPubMed Campero M, Serra J, Ochoa L (2005) Peripheral projections of sensory fascicles in the human superficial radial nerve. Brain 128:892–895CrossRefPubMed
5.
Zurück zum Zitat Chakravarthy Marx S, Kumar P, Dhalapathy S, Prasad K, Anitha Marx C (2009) Microanatomical and immunohistochemical study of the human radial nerve at the cubital fossa. Ann Anat 191:389–398CrossRefPubMed Chakravarthy Marx S, Kumar P, Dhalapathy S, Prasad K, Anitha Marx C (2009) Microanatomical and immunohistochemical study of the human radial nerve at the cubital fossa. Ann Anat 191:389–398CrossRefPubMed
6.
Zurück zum Zitat Dürr W (1990) Sudeck’s disease after radius fracture. Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir 693–699 Dürr W (1990) Sudeck’s disease after radius fracture. Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir 693–699
7.
Zurück zum Zitat Field J, Atkins RM (1997) Algodystrophy is an early complication of Colles’ fracture. What are the implications? J Hand Surg Br 22:178–182CrossRefPubMed Field J, Atkins RM (1997) Algodystrophy is an early complication of Colles’ fracture. What are the implications? J Hand Surg Br 22:178–182CrossRefPubMed
8.
Zurück zum Zitat Folberg CR, Ulson H Jr, Scheidt RB (2009) The superficial branch of the radial nerve: a morphologic study. Res Bras Ortop 44:69–74 Folberg CR, Ulson H Jr, Scheidt RB (2009) The superficial branch of the radial nerve: a morphologic study. Res Bras Ortop 44:69–74
9.
Zurück zum Zitat Grundberg AB, Reagan DS (1991) Compression syndromes in reflex sympathetic dystrophy. J Hand Surg Am 16:731–736CrossRefPubMed Grundberg AB, Reagan DS (1991) Compression syndromes in reflex sympathetic dystrophy. J Hand Surg Am 16:731–736CrossRefPubMed
10.
Zurück zum Zitat Hassantash SA, Maier RV (2000) Sympathectomy for causalgia: experience with military injuries. J Trauma 49:266–271CrossRefPubMed Hassantash SA, Maier RV (2000) Sympathectomy for causalgia: experience with military injuries. J Trauma 49:266–271CrossRefPubMed
11.
Zurück zum Zitat Horowitz SH (2000) Venipuncture-induced causalgia: anatomic relations of upper extremity superficial veins and nerves, and clinical considerations. Transfusion 40:1036–1040CrossRefPubMed Horowitz SH (2000) Venipuncture-induced causalgia: anatomic relations of upper extremity superficial veins and nerves, and clinical considerations. Transfusion 40:1036–1040CrossRefPubMed
12.
Zurück zum Zitat Hove LM (1995) Nerve entrapment and reflex sympathetic dystrophy after fractures of the distal radius. Scand J Plast Reconstr Surg Hand Surg 29:53–58CrossRefPubMed Hove LM (1995) Nerve entrapment and reflex sympathetic dystrophy after fractures of the distal radius. Scand J Plast Reconstr Surg Hand Surg 29:53–58CrossRefPubMed
13.
Zurück zum Zitat Jupiter JB, Seiler JG III, Zienowicz R (1994) Sympathetic maintained pain (causalgia) associated with a demonstrable peripheral-nerve lesion. Operative treatment. J Bone Joint Surg 76:1376–1384PubMed Jupiter JB, Seiler JG III, Zienowicz R (1994) Sympathetic maintained pain (causalgia) associated with a demonstrable peripheral-nerve lesion. Operative treatment. J Bone Joint Surg 76:1376–1384PubMed
14.
Zurück zum Zitat Konjengbam M, Elangbam J (2004) Radial nerve in the radial tunnel: anatomic sites of entrapment neuropathy. Clin Anat 17:21–25CrossRefPubMed Konjengbam M, Elangbam J (2004) Radial nerve in the radial tunnel: anatomic sites of entrapment neuropathy. Clin Anat 17:21–25CrossRefPubMed
15.
Zurück zum Zitat Kurvers HA, Hofstra L, Jacobs MJ, Daemen MA, van den Wildenberg FA, Kitslaar PJ, Slaaf DW, Reneman RS (1996) Reflex sympathetic dystrophy: does sympathetic dysfunction originate from peripheral neuropathy? Surgery 119:288–296CrossRefPubMed Kurvers HA, Hofstra L, Jacobs MJ, Daemen MA, van den Wildenberg FA, Kitslaar PJ, Slaaf DW, Reneman RS (1996) Reflex sympathetic dystrophy: does sympathetic dysfunction originate from peripheral neuropathy? Surgery 119:288–296CrossRefPubMed
16.
Zurück zum Zitat Lankford LL (1983) Reflex sympathetic dystrophy. In: Evarts CMCC (ed) Surgery of the musculo skeletal system, 1st edn. Churchill Livingstone, New York, pp 145–174 Lankford LL (1983) Reflex sympathetic dystrophy. In: Evarts CMCC (ed) Surgery of the musculo skeletal system, 1st edn. Churchill Livingstone, New York, pp 145–174
17.
Zurück zum Zitat Mackinnon SE, Dellon AL, Hudson AR, Hunter DA (1986) Histopathology of compression of the superficial radial nerve in the forearm. J Hand Surg Am 11:206–210PubMed Mackinnon SE, Dellon AL, Hudson AR, Hunter DA (1986) Histopathology of compression of the superficial radial nerve in the forearm. J Hand Surg Am 11:206–210PubMed
18.
Zurück zum Zitat Monsivais JJ, Baker J, Monsivais D (1993) The association of peripheral nerve compression and reflex sympathetic dystrophy. J Hand Surg Br 18:337–338CrossRefPubMed Monsivais JJ, Baker J, Monsivais D (1993) The association of peripheral nerve compression and reflex sympathetic dystrophy. J Hand Surg Br 18:337–338CrossRefPubMed
19.
Zurück zum Zitat Morgan RF, Reisman NR, Wilgis EF (1983) Anatomic localization of sympathetic nerves in the hand. J Hand Surg Am 8:283–288PubMed Morgan RF, Reisman NR, Wilgis EF (1983) Anatomic localization of sympathetic nerves in the hand. J Hand Surg Am 8:283–288PubMed
20.
Zurück zum Zitat Placzek JD, Boyer MI, Gelberman RH, Sopp B, Goldfarb CA (2005) Nerve decompression for complex regional pain syndrome type II following upper extremity surgery. J Hand Surg Am 30:69–74CrossRefPubMed Placzek JD, Boyer MI, Gelberman RH, Sopp B, Goldfarb CA (2005) Nerve decompression for complex regional pain syndrome type II following upper extremity surgery. J Hand Surg Am 30:69–74CrossRefPubMed
21.
Zurück zum Zitat Rikli DA, Businger A, Babst R (2005) Dorsal double-plate fixation of the distal radius. Oper Orthop Traumatol 17:624–640CrossRefPubMed Rikli DA, Businger A, Babst R (2005) Dorsal double-plate fixation of the distal radius. Oper Orthop Traumatol 17:624–640CrossRefPubMed
22.
Zurück zum Zitat Schmid C, Tjan TD, Scheld HH (2002) Severe complex regional pain syndrome type II after radial artery harvesting. Ann Thorac Surg 74:1250–1251CrossRefPubMed Schmid C, Tjan TD, Scheld HH (2002) Severe complex regional pain syndrome type II after radial artery harvesting. Ann Thorac Surg 74:1250–1251CrossRefPubMed
23.
Zurück zum Zitat Spinner M, Spencer PS (1974) Nerve compression lesions of the upper extremity. A clinical and experimental review. Clin Orthop Relat Res 104:46–67CrossRefPubMed Spinner M, Spencer PS (1974) Nerve compression lesions of the upper extremity. A clinical and experimental review. Clin Orthop Relat Res 104:46–67CrossRefPubMed
24.
Zurück zum Zitat Standring S (2008) Gray’s anatomy, 40th edn. Churchill Livingstone, New York, pp 829–856 Standring S (2008) Gray’s anatomy, 40th edn. Churchill Livingstone, New York, pp 829–856
25.
Zurück zum Zitat Sunderland S (1978) Nerve and nerve injuries, 2nd edn. Churchill Livingstone, Edinburgh, pp 827–828 Sunderland S (1978) Nerve and nerve injuries, 2nd edn. Churchill Livingstone, Edinburgh, pp 827–828
26.
Zurück zum Zitat Teasdall RD, Smith BP, Koman LA (2004) Complex regional pain syndrome (reflex sympathetic dystrophy). Clin Sports Med 23:145–155CrossRefPubMed Teasdall RD, Smith BP, Koman LA (2004) Complex regional pain syndrome (reflex sympathetic dystrophy). Clin Sports Med 23:145–155CrossRefPubMed
27.
Zurück zum Zitat Visser LH (2009) High-resolution sonography of the superficial radial nerve with two case reports. Muscle Nerve 39:392–395CrossRefPubMed Visser LH (2009) High-resolution sonography of the superficial radial nerve with two case reports. Muscle Nerve 39:392–395CrossRefPubMed
28.
Zurück zum Zitat Weiner RS (2002) Pain management: a practical guide for clinicians, 6th edn. CRC press, New York, pp 220–221 Weiner RS (2002) Pain management: a practical guide for clinicians, 6th edn. CRC press, New York, pp 220–221
29.
Zurück zum Zitat Wong GY, Wilson PR (1997) Classification of complex regional pain syndromes. New concepts. Hand Clin 13:319–325PubMed Wong GY, Wilson PR (1997) Classification of complex regional pain syndromes. New concepts. Hand Clin 13:319–325PubMed
30.
Zurück zum Zitat Zollinger PE, Tuinebreijer WE, Kreis RW, Breederveld RS (1999) Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial. Lancet 354:2025–2028CrossRefPubMed Zollinger PE, Tuinebreijer WE, Kreis RW, Breederveld RS (1999) Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial. Lancet 354:2025–2028CrossRefPubMed
Metadaten
Titel
Distribution of sympathetic fiber areas of radial nerve in the forearm: an immunohistochemical study in cadavers
verfasst von
S. Chakravarthy Marx
Pramod Kumar
S. Dhalapathy
C. Anitha Marx
A. S. D’Souza
Publikationsdatum
01.11.2010
Verlag
Springer-Verlag
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 9/2010
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-010-0648-y

Weitere Artikel der Ausgabe 9/2010

Surgical and Radiologic Anatomy 9/2010 Zur Ausgabe

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.