22.02.2021 | Original Article
Wichtige Hinweise
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The purpose of this study was to analyse the anatomic course of the radial nerve (RN) in the arm, in order to minimize the potential risk of surgical injury.
The study was performed in 19 embalmed upper extremities of 11 adult human cadavers. We measured: distance from deltoid insertion (DI) into the humerus to lateral epicondyle (LE); distance from RN piercing point into the lateral intermuscular septum (LIS) to three other points—DI, LE and RN division into superficial and deep terminal branches; distance between the LE and the RN division. To assess variability, we correlated the distances between the landmarks to the overall length of the arm.
The RN was found to pierce the LIS within 31.6 mm of the most distal DI into the humerus. The mean distance between the entry point of RN in the LIS and the LE was 107.2 mm. The mean distance between RN perforating point in the LIS and RN division in its terminal branches was 86.4 mm. The DI-LE and the LIS-LE showed a moderate positive correlation with the length of the arm.
We describe the DI relationship to the RN course and also report its proportion within overall arm length which has not been previously described. Using the arm length as reference, our results show that RN can be found to perforate on the LIS at a point distal to the DI by 11% and proximal to the LE by 38%.
Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten
★ PREMIUM-INHALT
e.Med Interdisziplinär
Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag als Mediziner
Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.
*
Sie können e.Med Interdisziplinär 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.
Anzeige
1.
Zurück zum Zitat Bono CM, Grossman MG, Hochwald N, Tornetta P (2000) Radial and axillary nerves. anatomic considerations for humeral fixation. Clin Orthop Relat Res 373:259–264 CrossRef Bono CM, Grossman MG, Hochwald N, Tornetta P (2000) Radial and axillary nerves. anatomic considerations for humeral fixation. Clin Orthop Relat Res 373:259–264
CrossRef
2.
Zurück zum Zitat Carlan D, Pratt J, Patterson JM, Weiland AJ, Boyer MI, Gelberman RH (2007) The radial nerve in the brachium: an anatomic study in human cadavers. J Hand Surg Am 32:1177–1182 CrossRef Carlan D, Pratt J, Patterson JM, Weiland AJ, Boyer MI, Gelberman RH (2007) The radial nerve in the brachium: an anatomic study in human cadavers. J Hand Surg Am 32:1177–1182
CrossRef
3.
Zurück zum Zitat Wang JP, Shen WJ, Chen WM, Huang CK, Shen YS, Chen TH (2009) Iatrogenic radial nerve palsy after operative management of humeral shaft fractures. J Trauma 66:800–803 CrossRef Wang JP, Shen WJ, Chen WM, Huang CK, Shen YS, Chen TH (2009) Iatrogenic radial nerve palsy after operative management of humeral shaft fractures. J Trauma 66:800–803
CrossRef
4.
Zurück zum Zitat Romanes GJ (1981) Cunningham’s textbook Of anatomy. Oxford University Press, New York Romanes GJ (1981) Cunningham’s textbook Of anatomy. Oxford University Press, New York
5.
Zurück zum Zitat Tank P (2013) Grant’s Dissector. Wolters Kluwer | Lippincott Williams & Wilkins, London. Tank P (2013) Grant’s Dissector. Wolters Kluwer | Lippincott Williams & Wilkins, London.
6.
Zurück zum Zitat Standring S (2016) Gray’s anatomy - the anatomical basis of clinical practice. Elsevier Limited, London Standring S (2016) Gray’s anatomy - the anatomical basis of clinical practice. Elsevier Limited, London
7.
Zurück zum Zitat Chang G, Ilyas AM (2018) Radial nerve palsy after humeral shaft fractures: the case for early exploration and a new classification to guide treatment and prognosis. Hand Clin 34:105–112 CrossRef Chang G, Ilyas AM (2018) Radial nerve palsy after humeral shaft fractures: the case for early exploration and a new classification to guide treatment and prognosis. Hand Clin 34:105–112
CrossRef
8.
Zurück zum Zitat Park KJ, Romero BA, Ahmadi S (2019) Identification of radial nerve in relationship to deltoid tuberosity and brachioradialis. Arch Bone Jt Surg 7:246–250 PubMedPubMedCentral Park KJ, Romero BA, Ahmadi S (2019) Identification of radial nerve in relationship to deltoid tuberosity and brachioradialis. Arch Bone Jt Surg 7:246–250
PubMedPubMedCentral
9.
Zurück zum Zitat Seigerman DA, Choung EW, Yoon RS, Lu M, Frank MA, Gaines LC et al (2012) Identification of the radial nerve during the posterior approach to the humerus: a cadaveric study. J Orthop Trauma 26:226–228 CrossRef Seigerman DA, Choung EW, Yoon RS, Lu M, Frank MA, Gaines LC et al (2012) Identification of the radial nerve during the posterior approach to the humerus: a cadaveric study. J Orthop Trauma 26:226–228
CrossRef
10.
Zurück zum Zitat Cox CL, Riherd D, Tubbs RS, Bradley E, Lee DH (2010) Predicting radial nerve location using palpable landmarks. Clin Anat 23:420–426 CrossRef Cox CL, Riherd D, Tubbs RS, Bradley E, Lee DH (2010) Predicting radial nerve location using palpable landmarks. Clin Anat 23:420–426
CrossRef
11.
Zurück zum Zitat Guse TR, Ostrum RF (1995) The surgical anatomy of the radial nerve around the humerus. Clin Orthop Relat Res 320:149–153 Guse TR, Ostrum RF (1995) The surgical anatomy of the radial nerve around the humerus. Clin Orthop Relat Res 320:149–153
12.
Zurück zum Zitat Fleming P, Lenehan B, Sankar R, Folan-Curran J, Curtin W (2004) One-third, two-thirds: relationship of the radial nerve to the lateral intermuscular septum in the arm. Clin Anat 17:26–29 CrossRef Fleming P, Lenehan B, Sankar R, Folan-Curran J, Curtin W (2004) One-third, two-thirds: relationship of the radial nerve to the lateral intermuscular septum in the arm. Clin Anat 17:26–29
CrossRef
13.
Zurück zum Zitat Chou PH, Shyu JF, Ma HL, Wang ST, Chen TH (2008) Courses of the radial nerve differ between chinese and Caucasians: clinical applications. Clin Anat 466:135–138 Chou PH, Shyu JF, Ma HL, Wang ST, Chen TH (2008) Courses of the radial nerve differ between chinese and Caucasians: clinical applications. Clin Anat 466:135–138
14.
Zurück zum Zitat Artico M, Telera S, Tiengo C, Stecco C, Macchi V, Porzionato A et al (2009) Surgical anatomy of the radial nerve at the elbow. Surg Radiol Anat 31:101–106 CrossRef Artico M, Telera S, Tiengo C, Stecco C, Macchi V, Porzionato A et al (2009) Surgical anatomy of the radial nerve at the elbow. Surg Radiol Anat 31:101–106
CrossRef
15.
Zurück zum Zitat Wegmann K, Lappen S, Pfau DB, Neiss WF, Muller LP, Burkhart KJ (2014) Course of the radial nerve in relation to the center of rotation of the elbow–the need for a rational safe zone for lateral pin placement. J Hand Surg Am 39:1136–1140 CrossRef Wegmann K, Lappen S, Pfau DB, Neiss WF, Muller LP, Burkhart KJ (2014) Course of the radial nerve in relation to the center of rotation of the elbow–the need for a rational safe zone for lateral pin placement. J Hand Surg Am 39:1136–1140
CrossRef
16.
Zurück zum Zitat Sukegawa K, Kuniyoshi K, Suzuki T, Matsuura Y, Onuma K, Kenmoku T et al (2018) Effects of the elbow flexion angle on the radial nerve location around the humerus: cadaver study for safe installation of a hinged external fixator. J Hand Surg Asian Pac 23:388–394 CrossRef Sukegawa K, Kuniyoshi K, Suzuki T, Matsuura Y, Onuma K, Kenmoku T et al (2018) Effects of the elbow flexion angle on the radial nerve location around the humerus: cadaver study for safe installation of a hinged external fixator. J Hand Surg Asian Pac 23:388–394
CrossRef
17.
Zurück zum Zitat Hackl M, Lappen S, Burkhart KJ, Leschinger T, Scaal M, Muller LP et al (2015) Elbow positioning and joint insufflation substantially influence median and radial nerve locations. ClinOrthopRelat Res 473:3627–3634 Hackl M, Lappen S, Burkhart KJ, Leschinger T, Scaal M, Muller LP et al (2015) Elbow positioning and joint insufflation substantially influence median and radial nerve locations. ClinOrthopRelat Res 473:3627–3634
18.
Zurück zum Zitat Van Sint JS, Van Nguyen D, Rooze M (2008) Quantified relationships of the radial nerve with the radial groove and selected humeral landmarks. Surg Radiol Anat 30:627–631 CrossRef Van Sint JS, Van Nguyen D, Rooze M (2008) Quantified relationships of the radial nerve with the radial groove and selected humeral landmarks. Surg Radiol Anat 30:627–631
CrossRef
19.
Zurück zum Zitat Patra A, Chaudhary P, Malhotra V, Arora K (2020) Identification of most consistent and reliable anatomical landmark to locate and protect radial nerve during posterior approach to humerus: a cadaveric study. Anat Cell Biol 53:132–136 CrossRef Patra A, Chaudhary P, Malhotra V, Arora K (2020) Identification of most consistent and reliable anatomical landmark to locate and protect radial nerve during posterior approach to humerus: a cadaveric study. Anat Cell Biol 53:132–136
CrossRef
- Titel
- Surgical anatomy of the radial nerve in the arm: a cadaver study
- Autoren:
-
Rita Sapage
Pedro A. Pereira
Luísa Vital
M. Dulce Madeira
André Pinho
- Publikationsdatum
- 22.02.2021
- DOI
- https://doi.org/10.1007/s00590-021-02916-2
- Verlag
- Springer Paris
- Zeitschrift
-
European Journal of Orthopaedic Surgery & Traumatology
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
-
Sie können e.Med Orthopädie & Unfallchirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.