Universität zu Köln

Hackl, M., Wegmann, K., Lappen, S., Helf, C., Burkhart, K. J. and Mueller, L. P. (2015). The course of the posterior interosseous nerve in relation to the proximal radius: Is there a reliable landmark? Injury-Int. J. Care Inj., 46 (4). S. 687 - 693. OXFORD: ELSEVIER SCI LTD. ISSN 1879-0267

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Abstract

Purpose: The posterior interosseous nerve (PIN) is closely related to the proximal radius, and it is at risk when approaching the proximal forearm from the ventral and lateral side. This anatomic study analyzes the location of the PIN in relation to the proximal radius depending on forearm rotation by means of a novel investigation design. The purpose of this study is to define landmarks to locate the PIN intraoperatively in order to avoid neurological complications. Methods: We dissected six upper extremities of fresh-frozen cadaveric specimens. The mean donor age at the time of death was 81.2 years. The PIN was dissected and marked on its course along the proximal forearm with a 0.3-mm flexible radiopaque thread. Three-dimensional (3D) X-ray scans were performed, and the location of the nerve was analyzed in neutral rotation, supination, and pronation. Results: In the coronal view, the PIN crosses the radial neck/shaft at a mean of 33.4 (+/- 5.9) mm below the radial head surface (RHS) in pronation and 16.9 (+/- 5.0) mm in supination. It crosses 4.9 (+/- 2.2) mm distal of the most prominent point of the radial tuberosity (RT) in pronation and 9.6 (+/- 5.2) mm proximal in supination. In the sagittal view, the PIN crosses the proximal radius 61.8 (+/- 2.9) mm below the RHS in pronation and 41.1 (+/- 3.6) mm in supination. The nerve crosses 29.2 (+/- 6.2) mm distal of the RT in pronation and 11.0 (+2.8) mm in supination. Conclusion: With this novel design, the RT could be defined as a useful landmark for intraoperative orientation. On a ventral approach, the PIN courses 10 mm proximal of it in supination and 5 mm distal of it in pronation. Laterally, pronation increases the distance of the PIN to the RT to approximately 3 cm. (C) 2015 Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hackl, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lappen, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Helf, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Burkhart, K. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, L. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-403715
DOI:	10.1016/j.injury.2015.01.028
Journal or Publication Title:	Injury-Int. J. Care Inj.
Volume:	46
Number:	4
Page Range:	S. 687 - 693
Date:	2015
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1879-0267
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FRACTURES; HEAD; REPAIR; TENDON Multiple languages Critical Care Medicine; Emergency Medicine; Orthopedics; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40371