Objective: The aim of this study was to add to the understanding of nerve branching patterns in the proximal forearm and consider optimal nerve transfer options to address the various injuries that affect the function of the upper extremity.
Methods: Eleven upper-extremity cadaveric specimens were dissected to expose the radial, median, and ulnar nerves in the proximal forearm. The site of origin of nerve branches from the major nerves was assessed, with measurements made in reference to the lateral epicondyle for the radial nerve branches and the medial epicondyle for the median and ulnar nerve branches. The distances to where these branches entered their respective muscles (muscle entry point) were assessed using the same landmarks. To plan a transfer, the length of the nerve branches was then calculated as the difference from the apparent origin from the main nerve trunk to the location where the nerve entered the muscle. Importantly, the nerve branch origin was established as the location of obvious separation from the main nerve trunk without additional fascicular dissection from the major nerve trunk. The number of branches was determined, and the diameter for each branch was measured using a Vernier caliper.
Results: The radial nerve branch to the extensor carpi radialis brevis (ECRB) muscle had an average length of 50.7 mm and average diameter of 1.6 mm. The mean medial and lateral lengths of the radial branches to the supinator muscle were found to be 22.2 mm (diameter 1.4 mm) and 15.3 mm (diameter 1.3 mm), respectively. The anterior interosseous nerve (AIN) branch of the median nerve was found 67.8 mm distal to the medial epicondyle with a diameter of 2.3 mm. The flexor carpi ulnaris (FCU) muscle innervation from the ulnar nerve was provided by 3 or 4 branches in most specimens. The second and third of these branches were the longest, with means of 30.5 mm (diameter 1.4 mm) and 30.7 mm (diameter 1.3 mm), respectively.
Conclusions: While there is variability of the nerve branching pattern in the proximal forearm between specimens, the authors provide evidence of commonalities (branching patterns and distances) that can facilitate planning for upper-extremity nerve reconstructions. Importantly, all measurements are provided with reference to easily identified bony landmarks and to their muscle entry points to aid operative decision-making. These data complement the growing practice of nerve transfers in the upper extremity for a variety of pathologies.
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http://dx.doi.org/10.3171/2023.5.SPINE23210 | DOI Listing |
Int J Surg
October 2024
Department of Surgery, Sapienza University of Rome, Rome, Italy.
Background: One of the most important surgical steps during thyroidectomy is the safe ligation of vessels. In fact, it is crucial to avoid postoperative bleeding and nerves' injury. The "clamp and tie" technique was first introduced in the 19th century.
View Article and Find Full Text PDFJ Am Acad Orthop Surg
December 2024
From the Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT (Graesser), the Washington University School of Medicine in St. Louis, Mallinckrodt Institute of Radiology, St. Louis, MO (Parsons), and the Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO (Olafsen, Dy, and Brogan).
Traumatic peripheral nerve injuries represent a spectrum of conditions and remain challenging to diagnose and prognosticate. High-resolution ultrasonography and magnetic resonance neurography have emerged as useful diagnostic modalities in the evaluation of traumatic peripheral nerve and brachial plexus injuries. Ultrasonography is noninvasive, is able to rapidly interrogate large areas and multiple nerves, allows for a dynamic assessment of nerves and their surrounding anatomy, and is cost-effective.
View Article and Find Full Text PDFHernia
December 2024
Department of Surgery, Tsudanuma Central General Hospital, 1- 9-17 Yatsu, Narashino, Japan.
Purpose: In laparoscopic inguinal hernia surgery, proper recognition of loose connective tissue, nerves, vas deferens, and microvessels is important to prevent postoperative complications, such as recurrence, pain, sexual dysfunction, and bleeding. EUREKA (Anaut Inc., Tokyo, Japan) is a system that uses artificial intelligence (AI) for anatomical recognition.
View Article and Find Full Text PDFSports Med Arthrosc Rev
October 2024
Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
This study was to investigate the efficacy of ultrasound-guided genicular nerve block for patients who underwent knee arthroscopy. Patients were randomized into two groups: 1. nerve block group: ultrasound-guided genicular nerve block (superomedial, superolateral and inferomedial genicular nerve, 2-ml 0.
View Article and Find Full Text PDFACS Nano
December 2024
Department of Pharmacy, Nanjing Medical Center for Clinical Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China.
Neural stem cell (NSCs) transplantation is a promising therapeutic strategy for spinal cord injury (SCI), but its efficacy is greatly limited by the local inhibitory microenvironment. In this study, based on l-arginine (l-Arg)-loaded mesoporous hollow cerium oxide (AhCeO) nanospheres, we constructed an injectable composite hydrogel (AhCeO-Gel) with microenvironment modulation capability. AhCeO-Gel protected NSCs from oxidative damage by eliminating excess reactive oxygen species while continuously delivering Nitric Oxide to the lesion of SCI in a pathological microenvironment, the latter of which effectively promoted the neural differentiation of NSCs.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!