Minimally invasive approach to the radial nerve – A new technique. Issue 12 (December 2015)

• Record Type: Journal Article
• Authors: Matzi, V.; Hörlesberger, N.; Hohenberger, G.M.; Rosenlechner, D.; Dolcet, C.; Weiglein, A.H.; Maier, M.J.; Grechenig, St.
• Is Part Of: Injury. Volume 46:Issue 12(2015)
• Page Start: 2374
• Page End: 2378
• Publication Date: 2015-12
• Subjects: Radial nerve -- Humerus shaft -- Posterior antebrachial cutaneous nerve -- Minimally invasive plate osteosynthesis; Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2015.09.017
• Languages: English
• ISSNs: 0020-1383

Abstract

Abstract: Purpose: To describe a minimally invasive approach to find the radial nerve (RN) simply and safely by tracing the posterior antebrachial cutaneous nerve (PACN) without damaging muscles, using only the surgeon's hand to define a window for the skin incision. Background: Although it is absolutely necessary to locate the radial nerve during osteosynthesis of the humerus, the literature lacks guidelines on how to do so. Methods: We have dissected the upper extremities of 54 adult human cadavers, embalmed using Thiel's method. After the PACN was identified in a defined space, its course was traced proximally by incising the lateral intermuscular septum (LIS) of the upper arm and thereby reaching the radial nerve (RN). Subsequently, using the lateral epicondyle (LE) of the humerus as a reference point, the distances to the points where the PACN perforated the LIS, and where the RN was identified, were measured. These individual data were related to the total length of the humerus. Results: The results indicate that with this approach and without harming musculature, the RN can be reached by tracing the PACN at a height of 11.1–13.0 cm (females) and 11.9–14.0 cm (males) starting from the LE. Conclusion: Our examination shows the PACN to be a convenient guide to the RN.