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Surgical and Radiologic Anatomy

, Volume 40, Issue 9, pp 1025–1030 | Cite as

Safe zone for the posterior interosseous nerve with regard to the lateral and posterior approaches to the proximal radius

  • Gloria Maria Hohenberger
  • Angelika Maria Schwarz
  • Marco Johannes Maier
  • Peter Grechenig
  • Jan Dauwe
  • Christoph Grechenig
  • Renate Krassnig
  • Axel Gänsslen
  • Andreas Heinrich Weiglein
Original Article
  • 113 Downloads

Abstract

Purpose

The posterior interosseous nerve (PIN) is at risk during the posterior and lateral approaches to the proximal radius. We aimed to define a safe zone for these approaches to avoid injury of the PIN and to evaluate their close and changing relationship to the nerve during forearm rotation.

Methods

The study collective consisted of 50 upper limbs. After performance of the lateral approach, the distance between the tip of the radial head and the PIN’s exit point from the supinator (= distance 1) and the shortest interval between the nerve’s exit to the radial margin of the ulna (= distance 2) were measured in maximum pronation and supination. Then, the dorsal approach was conducted and again distance 1 and the interval between the distal margin of the anconeus and the nerve’s exit point (distance 2) were evaluated (pronation and supination).

Results

There were significantly shorter distances during supination in comparison to pronation. Regarding the lateral approach, distance 1 changed from a mean of 60.3 mm (supination) to 62.7 mm in pronation (p < 0.001). For the dorsal approach, distance 1 decreased significantly (p < 0.001) from 62.9 mm (pronation) to 60.2 mm (supination).

Conclusion

Supination during the lateral and dorsal approaches to the proximal radius needs to be avoided to protect the PIN. Furthermore, the nerve appeared at an interval between 45 and 84.1 mm (lateral approach) and 47.5–93.8 mm (dorsal approach), respectively. Therefore, care must be taken at this height during extension of the approaches in a distal direction.

Keywords

Posterior interosseous nerve Proximal radius fracture Lateral approach radius Posterior approach radius 

Notes

Author contributions

GMH: Protocol development; data collection; manuscript writing. AMS: Protocol development; data collection; manuscript editing. MJM: Data analysis; manuscript writing & editing. PG: Data collection; manuscript editing. JD: Data collection; manuscript editing. CG: Data collection; manuscript editing. RK: Data collection; manuscript editing. AG: Protocol development; manuscript editing. AHW: Protocol development; manuscript writing & editing.

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the body donors during their lifetime.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Gloria Maria Hohenberger
    • 1
  • Angelika Maria Schwarz
    • 2
  • Marco Johannes Maier
    • 3
  • Peter Grechenig
    • 4
  • Jan Dauwe
    • 5
  • Christoph Grechenig
    • 4
  • Renate Krassnig
    • 1
  • Axel Gänsslen
    • 6
  • Andreas Heinrich Weiglein
    • 7
  1. 1.Department of Orthopaedics and Trauma SurgeryMedical University of GrazGrazAustria
  2. 2.AUVA Trauma Hospital GrazGrazAustria
  3. 3.ViennaAustria
  4. 4.Medical University of GrazGrazAustria
  5. 5.Department of Orthopaedic SurgeryUniversity Hospitals Leuven, Campus PellenbergPellenbergBelgium
  6. 6.Trauma DepartmentKlinikum WolfsburgWolfsburgGermany
  7. 7.Institute of AnatomyMedical University of GrazGrazAustria

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