Anterior transposition of the radial nerve to achieve primary suture for its reconstruction: Anatomical feasibility study
Language English Country Netherlands Media print-electronic
Document type Journal Article
PubMed
38118360
DOI
10.1016/j.bjps.2023.11.045
PII: S1748-6815(23)00771-4
Knihovny.cz E-resources
- Keywords
- Anterior nerve transposition, Brachial plexus injury, Nerve suture, Radial nerve palsy,
- MeSH
- Bone Plates MeSH
- Humans MeSH
- Radial Nerve * surgery MeSH
- Neuroma * MeSH
- Feasibility Studies MeSH
- Sutures MeSH
- Fracture Fixation, Internal methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
INTRODUCTION: Radial nerve palsy after humeral shaft fractures is often associated with formation of a neuroma in continuity. The current standard of treatment is neuroma resection and nerve grafting with contentious results. Anterior transposition of the radial nerve may reduce the length of its path, allowing reconstruction by primary suture. The aim of this study was to determine the maximum length of radial nerve defect that can be treated by the anterior transposition to allow primary suture to be performed. METHODS: We use 10 arms from five fresh cadavers. The radial nerve was dissected in the lateral inter-muscular septum and along the anterior aspect of the forearm. The radial nerve was transected at the level of the spiral groove and both stumps were than transposed anterior to the medial inter-muscular septum. The length of tension-free overlap that could be achieved was measured. RESULTS: The average length of the overlap at zero degrees of elbow flexion was 10.00 ± 1.84 mm. Theoretically, this will allow a defect of 20 ± 3.69 mm SD to be treated by primary suture. CONCLUSION: Our results suggest that anterior transposition can be used for radial nerve defects up to 2 cm; however, dissection of both stumps proved to be challenging.
3rd Faculty of Medicine Charles University Prague Czech Republic
Department of Anatomy 1st Faculty of Medicine Charles University Prague Czech Republic
Department of Forensic Medicine University Hospital Královské Vinohrady Prague Czech Republic
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