Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft · 2026
Anatomy of the Radial Recurrent Artery at the Entrance of the Supinator Canal and Its Relevance to Decompression of the Deep Branch of the Radial Nerve.
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Benes Michal, Kachlikova Helena, Kunc Vojtech, Kachlik David
Аннотация
PURPOSE: Radial recurrent artery (RRA) has been reported as a potential entrapment site for the deep branch of the radial nerve (DBRN). This anatomical study aimed to describe the branching patterns and topography of the RRA at the entrance of the supinator canal to better understand this cause of posterior interosseous nerve (PIN) palsy and enhance surgical precision in nerve decompression procedures.
METHODS: A total of 160 formaldehyde-preserved donated upper limbs were utilized in this study. The RRA and its branches forming the leash of Henry (LoH) were exposed and analyzed. The topography in relation to the DBRN was recorded.
RESULTS: The RRA most commonly originated from the radial artery (89.4%), and coursed above the tendon of the biceps brachii muscle (93.8%). The LoH consisted of an average of 3.9 branches, with the most frequent configuration being two proximal and two distal branches (20.6%). The RRA coursed superficial to the DBRN in 60.6% and deep in 39.4% of cases; however, at least one LoH branch consistently crossed superficial to the DBRN. In 30.6% of cases, at least one arterial branch entered the supinator canal. Accessory RRA was present in 22.5% of cases.
CONCLUSIONS: The RRA, including LoH, features variable anatomy at the entrance of the supinator canal, making several topographical arrangements potentially prone to cause DBRN compression. Despite this variability, consistent anatomical features, such as the presence of at least one arterial branch crossing superficial to the DBRN, were identified.
CLINICAL RELEVANCE: Understanding the variability and consistent features of the RRA and LoH may help surgeons obtain accurate clinical diagnosis, and may improve surgical safety during decompression procedures by anticipating vascular structures and potential bleeding sources.
METHODS: A total of 160 formaldehyde-preserved donated upper limbs were utilized in this study. The RRA and its branches forming the leash of Henry (LoH) were exposed and analyzed. The topography in relation to the DBRN was recorded.
RESULTS: The RRA most commonly originated from the radial artery (89.4%), and coursed above the tendon of the biceps brachii muscle (93.8%). The LoH consisted of an average of 3.9 branches, with the most frequent configuration being two proximal and two distal branches (20.6%). The RRA coursed superficial to the DBRN in 60.6% and deep in 39.4% of cases; however, at least one LoH branch consistently crossed superficial to the DBRN. In 30.6% of cases, at least one arterial branch entered the supinator canal. Accessory RRA was present in 22.5% of cases.
CONCLUSIONS: The RRA, including LoH, features variable anatomy at the entrance of the supinator canal, making several topographical arrangements potentially prone to cause DBRN compression. Despite this variability, consistent anatomical features, such as the presence of at least one arterial branch crossing superficial to the DBRN, were identified.
CLINICAL RELEVANCE: Understanding the variability and consistent features of the RRA and LoH may help surgeons obtain accurate clinical diagnosis, and may improve surgical safety during decompression procedures by anticipating vascular structures and potential bleeding sources.