The anatomical relationship of the superficial branches of radial nerve: a cadaveric study

Authors

  • Renu Gupta Department of Anatomy, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
  • Surajit Ghatak Department of Anatomy, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
  • Ashish Kumar Nayyar Department of Anatomy, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20241554

Keywords:

Inferior lateral cutaneous nerve of arm, Lateral epicondyle, Lateral intermuscular septum, Posterior cutaneous nerve of forearm

Abstract

Background: The major superficial branches of the radial nerve like inferior lateral cutaneous nerve of arm (ILCNA) and posterior cutaneous nerve of forearm (PCNF) are susceptible to get injured during surgical procedure done in distal half of humerus.

Methods: In this study 25 voluntary donated cadavers were dissected to define the course and position ILCNA and PCNF of the radial nerve and their ramifications in relation to anatomical landmarks such as the lateral inter muscular septum or bony landmarks such as lateral epicondyle.

Results: The inferior lateral cutaneous nerve of the arm arose from the radial nerve at the lower part of the spiral groove, at a mean of 14.8 cm proximal to the lateral epicondyle and 4.2 cm proximal to the uppermost fibres of the brachioradialis muscle. The posterior cutaneous nerve of the forearm arose from the inferior lateral cutaneous nerve at a mean of 6.7 cm proximal to the lateral epicondyle.

Conclusions: The described lateral approach permits assessment of any part of the radial nerve and reduces the risk of iatrogenic injury.

References

Standring S. Gray’s Anatomy: the anatomical basis of clinical practice. 1st ed. Edinburg: Churchill Livingstone/ Elsevier; 2016:783.

Blackburn SC, Wood CP, Evans DJ, Watt DJ. Radial nerve contribution to brachialis in the UK Caucasian population: position is predictable based on surface landmarks. Clin Anat. 2007;20(1):64-7.

Frazer EA, Hobson M, McDonald SW. The distribution of the radial and musculocutaneous nerves in the brachialis muscle. Clin Anat. 2007;20(7):785-9.

Mahakkanukrauh P, Somsarp V. Dual innervation of the brachialis muscle. Clin Anat. 2002;15(3):206-9.

Kretschmer T, Antoniadis G, Braun V, Rath SA, Richter HP. Evaluation of iatrogenic lesions in 722 surgically treated cases of peripheral nerve trauma. J Neurosurg. 2001;94(6):905-912.

Dellon AL, Kim J, Ducic I. Painful neuroma of the posterior cutaneous nerve of the forearm after surgery for lateral humeral epicondylitis. J Hand Surg Am. 2004;29(3):387-90.

Moran MC. Modified lateral approach to the distal humerus for internal fixation. Clin Orthop. 1997;340:190-7.

Bezes H, Massart P, Fourquet JP, Finet P, Tazi F, Tourné Y, et al. The value of combining multiple screwed plates in humeral shaft fractures. Int Orthop. 1995;19(1):16-25.

Lancaster G, Kozin SH, Porter S. The medial surgical approach to the humerus. Tech Hand Up Extrem Surg. 2000;4(3):201-6.

Dabezies EJ, Banta CJ, Murphy CP, d’Ambrosio RD. Plate fixation of the humeral shaft for acute fractures, with and without radial nerve injuries. J Orthop Trauma. 1992;6(1):10-13.

Gerwin M, Robert NH, Andrew JW. Alternative operative exposures of the posterior aspect of the humeral diaphysis with reference to the radial nerve. J Bone Joint Surg Br. 1996;78(11):1690-5.

Jupiter JB. Complex non-union of the humeral diaphysis: treatment with a medial approach, an anterior plate, and a vascularized fibular graft. J Bone Joint Surg Am. 1990;72(5):701-7.

Mills WJ, Hanel DP, Smith DG. Lateral approach to the humeral shaft: an alternative approach for fracture treatment. J Orthop Trauma. 1996;10(2):81-6.

Hannouche D, Ballis R, Raould A, Nizard RS, Masquelet AC. A lateral approach to the distal humerus following identification of the cutaneous branches of the radial nerve. J Bone J Surg Brit Vol. 2009;91(4):552-6.

Rouvière H. Human anatomy: descriptive, topographic and functional. In: Rouvière H, ed. Vol 3. 13th ed. Paris: Masson; 1967:2.

MacAvoy MC, Rust SS, Green DP. Anatomy of the posterior antebrachial cutaneous nerve: practical information for the surgeon operating on the lateral aspect of the elbow. J Hand Surg Am. 2006;31(6):908-11.

Gupta R, Nayyar AK, Ghatak S. Relation of radial nerve to superficial bony and soft tissue landmarks-a cadaveric study. Int J Res Med Sci. 2022;10(7):1503-7

Carlan D, Pratt J, Patterson JM, Weiland AJ, Boyer MI, Gelberman RH. The radial nerve in the brachium: an anatomic study in human cadavers. J Hand Surg Am. 2007;32(8):1177-82.

Downloads

Published

2024-05-31

How to Cite

Gupta, R., Ghatak, S., & Nayyar, A. K. (2024). The anatomical relationship of the superficial branches of radial nerve: a cadaveric study. International Journal of Research in Medical Sciences, 12(6), 2034–2037. https://doi.org/10.18203/2320-6012.ijrms20241554

Issue

Section

Original Research Articles