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Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2019

Fingerbreadths Rule in Determining the Safe Zone of the Radial Nerve and Posterior Interosseous Nerve for a Lateral Elbow Approach: An Anatomic Study.

СтатьяНазвание и аннотация: Перевод в очереди
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Simone Juan P, Streubel Philipp N, Sánchez-Sotelo Joaquín, Steinmann Scott P, Adams Julie E

Аннотация

INTRODUCTION: The purpose of this study was to investigate whether a safe zone rule could be applied to prevent iatrogenic injuries to the radial nerve (RN); and determine whether there is a relationship between the diameter of the radial head and capitellum and the distance of the posterior interosseous nerve (PIN) to the radiocapitellar joint.

METHODS: Ten fresh-frozen cadaveric specimens were used to measure the distances between the RN and the lateral epicondyle; the PIN and the radiocapitellar joint; the lateral epicondyle and the PIN as it crossed the ulnohumeral joint; the diameter of the radial head; the width of the capitellum; and the fingerbreadths of the specimens.

RESULTS: Four fingerbreadths determined a safe zone between the lateral epicondyle and the RN proximally at the point at which it pierced the intermuscular septum and the mid-lateral portion of the humeral shaft. Two fingerbreadths provided a safe zone for the PIN from the radiocapitellar joint to the midpoint of the axis of the radius only with the forearm in pronation.

CONCLUSION: A four-finger rule, two-finger rule, and radial head diameter or capitellum size may predict a safe zone for the RN and PIN except for the segment of the nerve where it crosses the anterior cortex of either the humerus or radius.

LEVEL OF EVIDENCE: Preclinical cadaveric study.

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

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