scholarly journals STRUTHERS’ LIGAMENT AND SUPRACONDYLAR HUMERAL PROCESS: AN ANATOMICAL STUDY AND CLINICAL IMPLICATIONS

2017 ◽  
Vol 25 (4) ◽  
pp. 137-142 ◽  
Author(s):  
Edie Benedito Caetano ◽  
João José Sabongi Neto ◽  
Luiz Angelo Vieira ◽  
Maurício Ferreira Caetano ◽  
José Eduardo de Bona ◽  
...  
Keyword(s):  
Median Nerve ◽  
Brachial Artery ◽  
Case Series ◽  
Anatomical Study ◽  
Nerve Compression ◽  
Clinical Implications ◽  
Level Of Evidence ◽  
Pronator Teres ◽  
Compressive Neuropathy ◽  
Anatomy Laboratory

ABSTRACT Objective: The objective of this study was to determine the frequency and anatomical characteristics of Struthers’ ligament and the supracondylar humeral process and evaluate the clinical implications in compressive neuropathy of the median nerve . Method: We dissected 60 arms from 30 cadavers (26 males and 4 females): 15 were previously preserved in formalin and glycerin and 15 were dissected fresh in the Anatomy Laboratory for this paper. The relationships between Struthers’ ligament and the median nerve and brachial artery and veins were documented with drawings and photos . Results: The supracondylar humeral process was not found in any of the 60 dissected arms. Struthers’ ligament was identified in six arms (two bilateral); in all cases high insertion of the pronator teres muscle was observed . Conclusion: Struthers’ ligament is an aponeurotic structure that may or may not be associated with the supracondylar humeral process, and is an important potential site of median nerve compression in the lower third of the arm. Level of Evidence IV, Case Series.

scholarly journals ARCADE OF FLEXOR DIGITORUM SUPERFICIALIS MUSCLE: ANATOMICAL STUDY AND CLINICAL IMPLICATIONS

2018 ◽  
Vol 26 (1) ◽  
pp. 36-40
Author(s):  
EDIE BENEDITO CAETANO ◽  
JOÃO JOSÉ SABONGI NETO ◽  
LUIZ ANGELO VIEIRA ◽  
MAURÍCIO FERREIRA CAETANO ◽  
JOSÉ EDUARDO DE BONA ◽  
...  
Keyword(s):  
Case Series ◽  
Anatomical Study ◽  
Nerve Compression ◽  
Clinical Implications ◽  
Flexor Digitorum Superficialis ◽  
Flexor Muscle ◽  
Level Of Evidence ◽  
Ulnar Head ◽  
A Site ◽  
Flexor Digitorum

ABSTRACT Objective: The arcade of the flexor digitorum superficialis muscle (FDS) is an anatomical structure which has not yet been widely studied and is a site of nerve compression. The aim of this study was to analyze the arcade of the FDS muscle and its relations with the median and anterior interosseous nerves through anatomic dissections. Method: Fifty arms from 25 adult cadavers (21 males and 4 females) were dissected; 18 were previously preserved in formalin and glycerin and 7 fresh specimens were dissected in the Laboratory of Anatomy. Results: The arcade of the superficial flexor muscle was identified in all dissected limbs. The radial and humeral heads were present in all specimens, and the ulnar head in 16 (32%). We identified two varieties of the arcade structure: a fibrous arcade in 32 specimens (64%), and a muscular arcade in 11 specimens (22%). In 4 specimens (8%) the arcade was very fine and so transparent that the nerve could be seen within the arcade. In 3 forearms the arcade was considered irregular because of discontinuity between the fibers that comprised this structure. Conclusion: The fibrous arcade of the FDS muscle may be a potential cause of nerve compression of the median and interosseous anterior nerves. Level of Evidence IV; Case series.

scholarly journals INNERVATION OF THE MEDIAN NERVE MOTOR BRANCHES IN THE FOREARM AND ITS CLINICAL SIGNIFICANCE

2020 ◽  
Vol 28 (5) ◽  
pp. 251-255
Author(s):  
EDIE BENEDITO CAETANO ◽  
JOÃO PAULO NUNES TOLEDO ◽  
SÉRGIO APARECIDO DO AMARAL JÚNIOR ◽  
LUIZ ANGELO VIEIRA ◽  
BEATRIZ D’ANDREA PIGOSSI ◽  
...  
Keyword(s):  
Median Nerve ◽  
Case Series ◽  
Anatomical Variations ◽  
Level Of Evidence ◽  
Pronator Teres ◽  
Nerve Transfers ◽  
Anterior Interosseous Nerve ◽  
Anatomy Laboratory ◽  
Flexor Digitorum ◽  
Normal Standard

ABSTRACT Objective: To analyse the anatomical variations of the median nerve motor branches in the elbow region. Methods: Twenty upper limbs of 10 adult male cadavers were prepared by intra-arterial injection of a solution of 10% glycerol and formaldehyde. All cadavers belonged to the institution anatomy laboratory. Results: We found a great variability within the distribution of median nerve branches leading to forearm muscles. Only three limbs (14%) presented the normal standard of innervation described in anatomy treatises. The pronator teres muscle (PTM), flexor carpi radialis (FCR), palmaris longus (PL), and the flexor digitorum superficialis (FDS) received exclusive innervation from the median nerve in all forearms. The anterior interosseous nerve (AIN) also originated from the median nerve in all dissected limbs. Conclusion: A thorough understanding of the anatomy of the median nerve branches is important for performing surgeries such as: approach to the proximal third of the forearm, alleviation of pronator teres and anterior interosseous nerve compression syndromes, and distal nerve transfers. It also enables a better understanding the recovery of muscle function after a nerve injury. Level of Evidence IV, Case series.

scholarly journals TRANSFER OF THE RADIAL NERVE BRANCHES FOR THE TREATMENT OF THE ANTERIOR INTEROSSEOUS NERVE LESION: AN ANATOMICAL STUDY

2019 ◽  
Vol 27 (6) ◽  
pp. 298-303
Author(s):  
Fernando César Matavelli Júnior ◽  
Lucas Gobbi ◽  
Marcos Paulo Sales dos Santos ◽  
Edie Benedito Caetano ◽  
Luiz Angelo Vieira ◽  
...  
Keyword(s):  
Median Nerve ◽  
Radial Nerve ◽  
Case Series ◽  
Anatomical Study ◽  
Flexor Digitorum Profundus ◽  
Common Trunk ◽  
Nerve Lesion ◽  
Level Of Evidence ◽  
Flexor Digitorum ◽  
Extensor Carpi Radialis

ABSTRACT Objective: This anatomical study aimed to analyze the possibility of transferring the radial nerve branches destined to the brachioradialis (BR), extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), and supinator (SM) muscles to innervate the AIN. Methods: Ten limbs from five male cadavers were prepared by intra-arterial injection of a solution of 10% glycerol and formalin. Results: The presence of only one branch to the BR muscle was noted in 7 limbs and two branches were noted in three limbs. In two members of a common trunk with branch to the ECRL. In eight cases, we identified one branch for the ERLC and two branches in two cases. We identified only one branch for the ECRB, while in six limbs, two branches were noted, penetrating the muscular body at two different points. We identified at least two branches innervating the supinator muscle. The AIN was detached from the median nerve distal to the intercondylar line of the humerus. In seven limbs, it originated from the nervous fascicles of the posterior region of the median nerve and from the posterolateral fascicles in three limbs. The flexor pollicis longus and flexor digitorum profundus muscles received more than one branch of the AIN in all limbs. Conclusion: The radial nerve branches for the ECRL, ECRB, and supinator muscles can be transferred directly to the AIN or to one of its branches after intraneural dissection, without tension even in elbow movements. Level of Evidence IV; Case series.

scholarly journals Flexor Pollicis Brevis Muscle. Anatomical Study and Clinical Implications

2017 ◽  
Vol 11 (1) ◽  
pp. 1321-1329
Author(s):  
Edie Benedito Caetano ◽  
Yuri da Cunha Nakamichi ◽  
Renato Alves de Andrade ◽  
Maico Minoru Sawada ◽  
Mauricio Tadeu Nakasone ◽  
...  
Keyword(s):  
Medical School ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Anatomical Study ◽  
Sao Paulo ◽  
Clinical Implications ◽  
Normal Pattern ◽  
Anatomical Dissection ◽  
Deep Branch ◽  
Catholic University

Introduction: This paper reports anatomical study of nature, incidence, innervation and clinical implications of Flexor Pollicis Brevis muscle (FPB). Material and Methods: The anatomical dissection of 60 limbs from 30 cadavers were performed in the Department of Anatomy of Medical School of Catholic University of São Paulo. Results: The superficial head of FPB has been innervated by the median nerve in 70% and in 30% it had double innervation. The deep head of FPB were absent in 14%, in 65%, occurred a double innervation. In 17.5% by deep branch of ulnar nerve and in 3.6% by recurrent branch of median nerve. Conclusion: The pattern of innervation more frequent in relationship to the flexor pollicis brevis muscle and should be considered as a normal pattern is that superficial head receives innervation of branches of median nerve and the deep head receives innervation of ulnar and median nerve.

Median nerve compression by an iatrogenic pseudoaneurysm of brachial artery

2004 ◽  
Vol 50 (3) ◽  
pp. 75-76
Author(s):  
Fernando Ruiz Santiago ◽  
Pilar Jiménez Villares ◽  
Juan Miguel Tristán Fernández ◽  
Fabiola Muñoz Parra
Keyword(s):  
Median Nerve ◽  
Brachial Artery ◽  
Nerve Compression ◽  
Median Nerve Compression ◽  
Iatrogenic Pseudoaneurysm

The scratch collapse test in the diagnosis of compression of the median nerve in the proximal forearm

2017 ◽  
Vol 42 (9) ◽  
pp. 937-940 ◽  
Author(s):  
Isidro Jiménez ◽  
Pedro J. Delgado
Keyword(s):  
Median Nerve ◽  
Nerve Compression ◽  
Clinical Usefulness ◽  
Level Of Evidence ◽  
Clinical Assessments ◽  
Proximal Forearm ◽  
Symptoms And Signs ◽  
Nerve Release

Our purpose was to review the clinical usefulness of the scratch collapse test (SCT) in the diagnosis of proximal entrapment of the median nerve in the forearm. Eighteen consecutive cases were reviewed. The diagnosis was based on the patient’s symptoms and signs. The SCT was positive in the affected forearm in all clinical assessments before surgery and it was negative in all after median nerve release. An anatomical reason for nerve compression was identified in all cases at operation. The SCT is a useful tool for the diagnosis of the proximal entrapment of the median nerve. Level of evidence: IV

Median Nerve Compression within the Humeral Head of Pronator Teres

1994 ◽  
Vol 19 (6) ◽  
pp. 709-710 ◽  
Author(s):  
N. TULWA ◽  
D. LIMB ◽  
R. F. BROWN
Keyword(s):  
Median Nerve ◽  
Humeral Head ◽  
Nerve Compression ◽  
Fibrous Band ◽  
Compression Neuropathy ◽  
Pronator Teres ◽  
Anterior Aspect ◽  
Pronator Syndrome ◽  
Anatomical Arrangement ◽  
A Site

We describe a case of the pronator syndrome caused by compression of the median nerve by a fibrous band as the nerve passed through the humeral head of origin of pronator teres. This rare anatomical arrangement resulted in displacement of the median nerve to the anterior aspect of the medial humeral epicondyle and, as far as we are aware, has not previously been described as a site of compression neuropathy.

scholarly journals Results of reoperation for failed ulnar nerve surgery at the elbow: a systematic review and meta-analysis

2019 ◽  
Vol 130 (3) ◽  
pp. 686-701 ◽  
Author(s):  
Tinatin Natroshvili ◽  
Erik T. Walbeehm ◽  
Nens van Alfen ◽  
Ronald H. M. A. Bartels
Keyword(s):  
Systematic Review ◽  
Ulnar Nerve ◽  
Meta Analysis ◽  
Case Series ◽  
Sensory Function ◽  
Nerve Compression ◽  
Cochrane Central Register ◽  
Level Of Evidence ◽  
Ulnar Nerve Compression ◽  
Failed Surgery

OBJECTIVEThe clinical results of reoperation for recurrent or persistent ulnar nerve compression at the elbow have not been clearly determined. The aim of this review was to determine overall improvement, residual pain, and sensory and motor deficits following reoperation regardless of the type of primary surgery performed for this condition.METHODSIn accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, a systematic review and meta-analysis of studies was performed. An independent librarian performed a literature search using Ovid MEDLINE, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Scale and the quality appraisal tool described by Moga et al. were used to assess the quality of included case series.RESULTSOf the 278 retrieved studies, 16 were eligible for analysis and included a total of 290 patients with failed surgery for ulnar nerve entrapment at the elbow. Relief of symptoms after reoperation was reported in 85% of patients. A decrease in pain was noted in 85% of the patients (95% CI 75%–93%). Only 2.4% of patients with preoperative pain experienced worse pain after reoperation. Motor and sensory function improvement was noted in 77% (95% CI 63%–88%) and 77% (95% CI 61%–90%) of cases, respectively. Complete recovery from signs and symptoms at the final follow-up was noted in 23% of elbows (95% CI 16%–31%).CONCLUSIONSAlthough the level of evidence of the included studies was low, the majority of patients had relief from their complaints after reoperation for recurrent or persistent ulnar nerve compression at the elbow following a previous surgery. The success rate of surgical treatment for a failed surgery was quite remarkable since almost a quarter of the patients completely recovered. Therefore, the authors recommend reoperation as a serious option for patients with this condition.

Supraretinacular endoscopic carpal tunnel release: surgical technique with prospective case series

2014 ◽  
Vol 40 (2) ◽  
pp. 193-198 ◽  
Author(s):  
J. Ecker ◽  
N. Perera ◽  
J. Ebert
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Case Series ◽  
Level Of Evidence ◽  
Motor Branch ◽  
Endoscopic Techniques ◽  
Endoscopic Carpal Tunnel Release ◽  
Flexor Retinaculum ◽  
Prospective Case Series

Current techniques for endoscopic carpal tunnel release use an infraretinacular approach, inserting the endoscope deep to the flexor retinaculum. We present a supraretinacular endoscopic carpal tunnel release technique in which a dissecting endoscope is inserted superficial to the flexor retinaculum, which improves vision and the ability to dissect and manipulate the median nerve and tendons during surgery. The motor branch of the median nerve and connections between the median and ulnar nerve can be identified and dissected. Because the endoscope is inserted superficial to the flexor retinaculum, the median nerve is not compressed before division of the retinaculum and, as a result, we have observed no cases of the transient median nerve deficits that have been reported using infraretinacular endoscopic techniques. Level of evidence: IV.

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