J Reconstr Microsurg 2016; 32(09): 670-674
DOI: 10.1055/s-0036-1584687
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Surgical Anatomy of the Radial Nerve at the Elbow and in the Forearm: Anatomical Basis for Intraplexus Nerve Transfer to Reconstruct Thumb and Finger Extension in C7 − T1 Brachial Plexus Palsy

Lei Zhang
1   Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
,
Zhen Dong
2   Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
,
Chun-Lin Zhang
1   Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
,
Yu-Dong Gu
2   Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
› Author Affiliations
Further Information

Publication History

09 April 2016

20 May 2016

Publication Date:
28 June 2016 (online)

Abstract

Background C7 − T1 palsy results in complete loss of finger motion and poses a surgical challenge. This study investigated the anatomy of the radial nerve in the elbow and forearm and the feasibility of intraplexus nerve transfer to restore thumb and finger extension.

Methods The radial nerves were dissected in 28 formalin-fixed upper extremities. Branching pattern, length, diameter, and number of myelinated fibers were recorded.

Results Commonly, the branching pattern (from proximal to distal) was to the brachioradialis, extensor carpi radialis longus, superficial sensory proximal to the lateral epicondyle, extensor carpi radialis brevis, supinator, extensor digitorum communis, extensor digiti minimi, extensor carpi ulnaris, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, and extensor indicis distal to the lateral epicondyle.

Conclusions Branches to the brachioradialis, extensor carpi radialis longus, and supinator can be transferred to the posterior interosseous nerve to restore hand movement in patients with C7 − T1 brachial plexus palsies; the supinator branch is probably the best choice in this regard.

 
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