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J Hand Microsurg 2023; 15(01): 041-044
DOI: 10.1055/s-0041-1722814
Original Article

Anatomical Assessment of Cephalic Vein and Superficial Branch of Radial Nerve Using High-Resolution Ultrasound Imaging

Atsuyuki Inui
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Yutaka Mifune
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Hanako Nishimoto
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Takashi Kurosawa
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Kohei Yamaura
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Shintaro Mukouhara
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Tomoya Yoshikawa
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Ryosuke Kuroda
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
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Abstract

Introduction The superficial branch of the radial nerve (SBRN) has a risk of nerve injury during cephalic vein (CV) cannulation. Due to the lack of imaging study regarding SBRN and CV relationship, we analyzed the anatomical relationship between the SBRN and the CV using ultrasound (US) imaging.

Materials and Methods In total, 82 upper limbs of 41 healthy volunteers were analyzed. The SBRN and CV were identified at the following three points in the elbow extension and pronation position: at the radial styloid process (point 1), 5 cm proximal to point 1 (point 2), and 10 cm proximal to point 1 (point 3).

Results The distance between the SBRN and CV was 1.1 ± 1.0 mm at point 1, 1.3 ± 1.3 mm at point 2, and 2.1 ± 1.6 mm at point 3. The depth of the SBRN from the surface of the skin was 2.7 ± 0.9 mm at point 1, 3.5 ± 1.1 mm at point 2, and 5.5 ± 1.9 mm at point 3. The percentage of the SBRN that ran beneath the CV was 17.5%, 53.5%, and 92.4% at points 1, 2, and 3, respectively.

Conclusion Ultrasonography can reveal the anatomical relationship between the SBRN and CV.

Keywords

superficial branch of radial nerve - cephalic vein - ultrasound


Publication History

Article published online:
07 February 2021

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  • References

  • 1 Kim KH, Byun EJ, Oh EH. Ultrasonographic findings of superficial radial nerve and cephalic vein. Ann Rehabil Med 2014; 38 (01) 52-56
    CrossrefPubMedGoogle Scholar
  • 2 Sheu JJ, Yuan RY. Superficial radial neuropathy following venepuncture. Int J Clin Pract 2001; 55 (06) 422-423
    CrossrefPubMedGoogle Scholar
  • 3 Boeson MB, Hranchook A, Stoller J. Peripheral nerve injury from intravenous cannulation: a case report. AANA J 2000; 68 (01) 53-57
    PubMedGoogle Scholar
  • 4 Ikiz ZA, Uçerler H. Anatomic characteristics and clinical importance of the superficial branch of the radial nerve. Surg Radiol Anat 2004; 26 (06) 453-458
    CrossrefPubMedGoogle Scholar
  • 5 Singh S, Trikha P, Twyman R. Superficial radial nerve damage due to Kirschner wiring of the radius. Injury 2005; 36 (02) 330-332
    CrossrefPubMedGoogle Scholar
  • 6 Kim DH, Kam AC, Chandika P, Tiel RL, Kline DG. Surgical management and outcome in patients with radial nerve lesions. J Neurosurg 2001; 95 (04) 573-583
    CrossrefPubMedGoogle Scholar
  • 7 Dellon AL, Mackinnon SE. Treatment of the painful neuroma by neuroma resection and muscle implantation. Plast Reconstr Surg 1986; 77 (03) 427-438
    CrossrefPubMedGoogle Scholar
  • 8 Meng S, Tinhofer I, Weninger WJ, Grisold W. Ultrasound and anatomical correlation of the radial nerve at the arcade of Frohse. Muscle Nerve 2015; 51 (06) 853-858
    CrossrefPubMedGoogle Scholar
  • 9 Licht NJ, Rowe DE, Ross LM. Pitfalls of pedicle screw fixation in the sacrum. A cadaver model. Spine 1992; 17 (08) 892-896
    CrossrefPubMedGoogle Scholar
  • 10 Tsukuda Y, Funakoshi T, Nasuhara Y, Nagano Y, Shimizu C, Iwasaki N. Venipuncture nerve injuries in the upper extremity from more than 1 million procedures. J Patient Saf 2019; 15 (04) 299-301
    CrossrefPubMedGoogle Scholar
  • 11 Newman BH, Waxman DA. Blood donation-related neurologic needle injury: evaluation of 2 years' worth of data from a large blood center. Transfusion 1996; 36 (03) 213-215
    CrossrefPubMedGoogle Scholar
  • 12 Thrush DN, Belsole R. Radial nerve injury after routine peripheral vein cannulation. J Clin Anesth 1995; 7 (02) 160-162
    CrossrefPubMedGoogle Scholar
  • 13 Robson AJ, See MS, Ellis H. Applied anatomy of the superficial branch of the radial nerve. Clin Anat 2008; 21 (01) 38-45
    CrossrefPubMedGoogle Scholar
  • 14 Mackinnon SE, Dellon AL. The overlap pattern of the lateral antebrachial cutaneous nerve and the superficial branch of the radial nerve. J Hand Surg Am 1985; 10 (04) 522-526
    CrossrefPubMedGoogle Scholar
  • 15 Omokawa S, Ryu J, Tang JB, Han J. Vascular and neural anatomy of the thenar area of the hand: its surgical applications. Plast Reconstr Surg 1997; 99 (01) 116-121
    CrossrefPubMedGoogle Scholar