Document Detail


Median nerve branches to the pronator teres: cadaveric study with potential use in neurotization procedures to the radial nerve at the elbow.
MedLine Citation:
PMID:  20380533     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Various donor nerves have been used for brachial plexus neurotization procedures. To the authors' knowledge, neurotization of median nerve branches to the pronator teres to the radial nerve at the elbow have not been explored.
METHODS: In an attempt to identify an additional nerve donor candidate for neurotization procedures of the upper limb, 20 cadaveric upper limbs underwent dissection of the cubital fossa and identification of branches of the median nerve to the pronator teres. Measurements were made of such branches, and distal transection was then performed to determine the appropriate length so that the structure could be brought to the laterally positioned radial nerve via tunneling deep to the biceps brachii muscle.
RESULTS: All specimens were found to have a median nerve branch to the pronator teres that was long enough to reach the radial nerve in the cubital fossa. Neural connections remained tension free with full pronation and supination. The mean length of these branches to the pronator teres was 3.6 cm. The overall mean diameter of these nerves was 1.5 mm. The mean proximal, midpoint, and distal diameters were 2.0, 1.8, and 1.5 mm, respectively. The mean distance between the origin of these branches to the pronator teres and the medial epicondyle of the humerus was 4.1 cm.
CONCLUSIONS: Based on the results of our cadaveric study, the use of the branch of the median nerve to the pronator teres muscle may be considered for neurotization of the radial nerve in the cubital fossa.
Authors:
R Shane Tubbs; Joshua M Beckman; Marios Loukas; Mohammadali M Shoja; Aaron A Cohen-Gadol
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Publication Detail:
Type:  Journal Article     Date:  2010-04-09
Journal Detail:
Title:  Journal of neurosurgery     Volume:  114     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-03     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  253-5     Citation Subset:  AIM; IM    
Affiliation:
Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama 35233, USA. rstubbs@uab.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cadaver
Elbow / anatomy & histology,  innervation*
Female
Forearm / anatomy & histology,  innervation
Humans
Humerus / anatomy & histology,  innervation
Male
Median Nerve / anatomy & histology,  surgery*
Middle Aged
Muscle, Skeletal / anatomy & histology,  innervation*
Nerve Transfer / methods*
Radial Nerve / anatomy & histology,  injuries,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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