CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(06): 764-770
DOI: 10.1055/s-0040-1713403
Artigo Original
Mão

Anatomical Study of the Motor Branches of the Radial Nerve in the Forearm[*]

Article in several languages: português | English
1   Departamento de Cirurgia, Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (FCMS/PUC-SP), Sorocaba, SP, Brasil
,
1   Departamento de Cirurgia, Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (FCMS/PUC-SP), Sorocaba, SP, Brasil
,
1   Departamento de Cirurgia, Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (FCMS/PUC-SP), Sorocaba, SP, Brasil
,
2   Serviço de Cirurgia da Mão, Conjunto Hospitalar de Sorocaba, Sorocaba, SP, Brasil
,
1   Departamento de Cirurgia, Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (FCMS/PUC-SP), Sorocaba, SP, Brasil
,
1   Departamento de Cirurgia, Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (FCMS/PUC-SP), Sorocaba, SP, Brasil
› Author Affiliations

Abstract

Objective To analyze the anatomical variations of the motor branches of the radial nerve in the elbow region. The origin, course, length, branches, motor points and relationships with neighboring structures were evaluated.

Materials and Methods Thirty limbs from15 adult cadavers were dissected and prepared by intra-arterial injection of a 10% glycerin and formaldehyde solution.

Results The first branch of the radial nerve in the forearm went to the brachioradialis muscle (BR), originating proximally to the division of the radial nerve into superficial branch of the radial nerve (SBRN) and posterior interosseous nerve (PIN) in all limbs. The branches to the extensor carpi radialis longus muscle (ECRL) detached from the proximal radial nerve to its division into 26 limbs, in 2, at the dividing points, in other 2, from the PIN. In six limbs, the branches to the BR and ECRL muscles originated from a common trunk. We identified the origin of the branch to the extensor carpi radialis brevis muscle (ECRB) in the PIN in 14 limbs, in the SBRN in 12, and in the radial nerve in only 4. The branch to the supinator muscle originated from the PIN in all limbs.

Conclusion Knowledge of the anatomy of the motor branches of the radial nerve is important when performing surgical procedures in the region (such as the approach of the proximal third and the head of the radius, release of compressive syndromes of the posterior interosseous nerve and radial tunnel, and distal nerve transfers) in order to understand the order of recovery of muscle function after a nerve injury.

* Work developed at the Department of Surgery, Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brazil.




Publication History

Received: 16 July 2019

Accepted: 10 March 2020

Article published online:
18 December 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • Referências

  • 1 Vergara-Amador E, Ramírez A. Anatomic study of the extensor carpi radialis brevis in its relation with the motor branch of the radial nerve. Orthop Traumatol Surg Res 2015; 101 (08) 909-912
  • 2 Spinner M. The arcade of Frohse and its relationship to posterior interosseous nerve paralysis. J Bone Joint Surg Br 1968; 50 (04) 809-812
  • 3 Safwat MD, Abdel-Meguid EM. Distribution of terminal nerve entry points to the flexor and extensor groups of forearm muscles: an anatomical study. Folia Morphol (Warsz) 2007; 66 (02) 83-93
  • 4 Liu J, Pho RW, Pereira BP, Lau HK, Kumar VP. Distribution of primary motor nerve branches and terminal nerve entry points to the forearm muscles. Anat Rec 1997; 248 (03) 456-463
  • 5 García-López A, Fernández E, Martínez F. Transfer of brachioradialis motor branch to the anterior interosseous nerve in C8-T1 brachial plexus palsy. An anatomic study. Microsurgery 2013; 33 (04) 297-300
  • 6 Bertelli JA, Ghizoni MF. Nerve transfers for restoration of finger flexion in patients with tetraplegia. J Neurosurg Spine 2017; 26 (01) 55-61
  • 7 Sunderland S. Metrical and non-metrical features of the muscular branches of the radial nerve. J Comp Neurol 1946; 85: 93-111
  • 8 Abrams RA, Ziets RJ, Lieber RL, Botte MJ. Anatomy of the radial nerve motor branches in the forearm. J Hand Surg Am 1997; 22 (02) 232-237
  • 9 Linell EA. The distribution of nerves in the upper limb, with reference to variabilities and their clinical significance. J Anat 1921; 55 (Pt 2-3): 79-112
  • 10 Fuss FK, Wurzl GH. Radial nerve entrapment at the elbow: surgical anatomy. J Hand Surg Am 1991; 16 (04) 742-747
  • 11 Branovacki G, Hanson M, Cash R, Gonzalez M. The innervation pattern of the radial nerve at the elbow and in the forearm. J Hand Surg [Br] 1998; 23 (02) 167-169
  • 12 Salsbury CR. The nerve to the extensor carpi radialis brevis. Br J Surg 1938; 26 (101) 95-97
  • 13 Cricenti SV, Deangelis MA, Didio LJA, Ebraheim NA, Rupp RE, Didio AS. Innervation of the extensor carpi radialis brevis and supinator muscles: Levels of origin and penetration of these muscular branches from the posterior interosseous nerve. J Shoulder Elbow Surg 1994; 3 (06) 390-394
  • 14 Nayak SR, Ramanathan L, Krishnamurthy A. et al. Extensor carpi radialis brevis origin, nerve supply and its role in lateral epicondylitis. Surg Radiol Anat 2010; 32 (03) 207-211
  • 15 Segal RL. Neuromuscular compartments in the human biceps brachii muscle. Neurosci Lett 1992; 140 (01) 98-102
  • 16 Clara M. Das nervensystem des menschen. 3rd ed. Leipzig: Barth; 1959
  • 17 Rosenstein A. Anatomie der peripheren nerven. In: Bumke O, Foerster O. editors Handbuch der neurologie. Berlin: Springer; 1935