Background: Neurological injuries are among the most reported complications of elbow arthroscopy. Several cadaveric studies have assessed the relationship between nerves and arthroscopic portals. To our knowledge, no studies evaluated the anconeus nerve. This anatomic study aimed to identify the course of the anconeus nerve and to investigate its anatomic relation with posterior elbow portals, providing useful information to preserve it during surgery.
Methods: Twelve fresh frozen elbows were dissected to isolate the radial nerve and its branch to the anconeus muscle. Distances between the anconeus nerve, olecranon tip, and lateral epicondyle were measured. Posterior, posterolateral and soft spot portals were created and their proximity to the nerve was measured.
Results: The anconeus nerve showed an average distance from the lateral epicondyle of 19.67 mm (SD 1.44 mm) and from the olecranon of 22.33 mm (SD 1.72 mm). The posterolateral portal was 1 mm medial to the nerve. The soft spot portal was located where the nerve enters the muscle.
Discussion: An important finding of this study was the closeness between the anconeus nerve and the posterolateral and soft spot portals, resulting in a high risk of nerve damage. More medial placement of the posterolateral portal may avoid anconeus nerve injury and consequent muscle denervation.
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http://dx.doi.org/10.1177/17585732231166938 | DOI Listing |
Reg Anesth Pain Med
December 2024
Division of Anatomy, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
J Shoulder Elbow Surg
November 2024
Ziekenhuis Oost-Limburg, department of orthopaedic surgery and traumatology, Schiepse Bos 6, 3600 Genk, Belgium; University of Hasselt, faculty of rehabilitation sciences. Martelarenlaan 42, 3500 Hasselt, Belgium. Electronic address:
Background: The role of the anconeus epitrochlearis (AE) in cubital tunnel syndrome, either as protector or potential compressor of the ulnar nerve, as well as its prevalence in both symptomatic and asymptomatic patients are still unclear. This study aimed to assess the prevalence of the AE in a large cohort using 3-dimensional imaging and to investigate any association of the AE with preoperative or postoperative features of patients undergoing cubital tunnel surgery.
Methods: From a database of 1240 elbow MRIs, all patients with an AE were retrospectively screened for major criteria of cubital tunnel syndrome.
This case shows the feasibility of targeted muscle reinnervation (TMR) in a patient with a traumatic neuroma of the medial antebrachial cutaneous nerve (MABCN). TMR was performed by connecting the proximal stump of the MABCN to the branch innervating the accessory epitrochleoanconeus muscle. Postoperatively, the patient reported significantly less pain.
View Article and Find Full Text PDFShoulder Elbow
July 2024
IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology Clinic - University of Bologna, Bologna, Italy.
Background: Neurological injuries are among the most reported complications of elbow arthroscopy. Several cadaveric studies have assessed the relationship between nerves and arthroscopic portals. To our knowledge, no studies evaluated the anconeus nerve.
View Article and Find Full Text PDFOper Orthop Traumatol
August 2024
Schwerpunkt für Unfall‑, Hand- und Ellenbogenchirurgie, Universitätsklinikum Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland.
Objective: Interposition arthroplasty of the elbow involves the interposition of a fascia lata or dermis autograft or allograft between the distal humerus and the ulna or radius, while preserving the original form of articulation.
Indications: Interposition arthroplasty is indicated for young patients with high functional demands who suffer from end-stage elbow arthritis and associated pain or joint stiffness.
Contraindications: Contraindications include acute or subacute infection, skeletal immaturity, bone loss, deformity, or gross instability.
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