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Tracking Anatomical Variation of the Bifurcation of the Radial Nerve: Clinical Implication for Physicians
Author(s) -
Solari Carissa,
Peralta Patricia,
Secko Michael,
Marquez Samuel
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.864.6
Subject(s) - calipers , medicine , radial nerve , forearm , anatomy , axillary nerve , elbow , brachial plexus , median nerve , mathematics , geometry
Regional nerve blocks of the upper limb are usually performed in the brachial plexus, specifically in the supra‐ or infra‐clavicular or axillary nerve regions, in cases where minor surgical procedures are required in the distal portion of the extremity. These approaches may not be optimal due to the close proximity of major vascular structures to the needle entry site. This quantitative study measured the site of the radial nerve bifurcation using calipers and ultrasound (US) to determine whether minor surgical procedures (i.e., wound exploration, laceration repair and distal radius reduction) could rely on nerve blocks within a single nerve distribution, in a defined region of the cubital fossa. A metal cylinder was aligned along the medial and lateral epicondyles of 59 donor body arms. A digital caliper, perpendicular to the cylinder, allowed for measurement above (+) or below (‐) the epicondylar line (0mm). The average bifurcation occurred at ‐13.84mm, with 85% of bifurcations arising in the forearm below 0mm. US digital data from a cross‐sectional sample of live patients were included in our analysis. US guided needle nerve blocks are presently used by physicians for cases involving injury distal to the elbow. Our results indicate that it is possible to establish “safe zone” parameters in regional nerve blocks to maximize functional recovery while minimizing collateral vascular damage.