Median nerve branches to the pronator teres: cadaveric study with potential use in neurotization procedures to the radial nerve at the elbow

2011 ◽  
Vol 114 (1) ◽  
pp. 253-255 ◽  
Author(s):  
R. Shane Tubbs ◽  
Joshua M. Beckman ◽  
Marios Loukas ◽  
Mohammadali M. Shoja ◽  
Aaron A. Cohen-Gadol
Keyword(s):  
Median Nerve ◽  
Radial Nerve ◽  
Biceps Brachii ◽  
Cadaveric Study ◽  
Nerve Branch ◽  
Neural Connections ◽  
Pronator Teres ◽  
Cubital Fossa ◽  
The Mean ◽  
Potential Use

Object Various donor nerves have been used for brachial plexus neurotization procedures. To the authors' knowledge, neurotization of median nerve branches to the pronator teres to the radial nerve at the elbow have not been explored. Methods In an attempt to identify an additional nerve donor candidate for neurotization procedures of the upper limb, 20 cadaveric upper limbs underwent dissection of the cubital fossa and identification of branches of the median nerve to the pronator teres. Measurements were made of such branches, and distal transection was then performed to determine the appropriate length so that the structure could be brought to the laterally positioned radial nerve via tunneling deep to the biceps brachii muscle. Results All specimens were found to have a median nerve branch to the pronator teres that was long enough to reach the radial nerve in the cubital fossa. Neural connections remained tension free with full pronation and supination. The mean length of these branches to the pronator teres was 3.6 cm. The overall mean diameter of these nerves was 1.5 mm. The mean proximal, midpoint, and distal diameters were 2.0, 1.8, and 1.5 mm, respectively. The mean distance between the origin of these branches to the pronator teres and the medial epicondyle of the humerus was 4.1 cm. Conclusions Based on the results of our cadaveric study, the use of the branch of the median nerve to the pronator teres muscle may be considered for neurotization of the radial nerve in the cubital fossa.

scholarly journals Aberrant Origin of Radial Artery in Arm

2016 ◽  
Vol 14 (1) ◽  
pp. 49-50
Author(s):  
Vivek Sathe ◽  
Rishi Pokhrel
Keyword(s):  
Radial Artery ◽  
Biceps Brachii ◽  
Axillary Artery ◽  
Deep Fascia ◽  
Lateral Side ◽  
Anterior Border ◽  
Lateral Region ◽  
Pronator Teres ◽  
Male Cadaver ◽  
Cubital Fossa

During dissection in middle-aged male cadaver, an aberrant radial artery was noticed in the left arm. The artery was taking origin from the upper part of the brachial artery i.e. at a point when axillary artery leaves the axilla and becomes brachial artery.Course of the aberrant vessel was studied in the arm and the forearm. In the upper part of arm the vessel took origin on the lateral side of brachial plexus trunks and traveled to the lateral region of the cubital fossa travelling lateral to the biceps brachii and deep to skin, superficial and deep fascia. In the lower part of the arm i.e. just above the cubital fossa, aberrant vessel was lateral and entered the forearm deep to the pronator teres. Throughout its course the vessel laid superficial to forearm muscles, it was covered by the skin superficial and deep fascia. At the wrist its position was normal i.e. against anterior border of the radius.

Delayed Transfer of the Extensor Carpi Radialis Brevis Branch of the Radial Nerve to the Anterior Interosseous Nerve for Restoration of Thumb and Index Finger Flexion: Case Report

2020 ◽  
Vol 81 (06) ◽  
pp. 571-574
Author(s):  
Renan Salomão ◽  
Jairo Porfírio de Oliveira ◽  
Carolina Fernandes Junger ◽  
Luiz Cezar Soares Ricardo ◽  
Carlos Roberto de Lima ◽  
...  
Keyword(s):  
Median Nerve ◽  
Radial Nerve ◽  
Spontaneous Recovery ◽  
Index Finger ◽  
Upper Extremities ◽  
Nerve Branch ◽  
Finger Flexion ◽  
Anterior Interosseous Nerve ◽  
Extensor Carpi Radialis ◽  
High Median

AbstractHigh median nerve injuries (HMNIs) are rare lesions involving the upper extremities and affect the median nerve from its origin to the emergence of the anterior interosseous nerve (AIN). Proximal reconstruction has long been considered the gold standard in treating HMNI, but thumb and index flexion and pinch and grip weakness are consistently not recovered. We report the surgical results of a patient affected by an HMNI with partial spontaneous recovery after a gunshot wound. AIN function was successfully restored in a delayed fashion by transferring the radial nerve branch to the extensor carpi radialis brevis to the AIN.

scholarly journals Uncommon course of the ulnar artery through the pronator teres muscle

1970 ◽  
Vol 52 (195) ◽  
pp. 946-948
Author(s):  
Katerina Vymazalová ◽  
Lenka Vargová ◽  
Marek Joukal
Keyword(s):  
Median Nerve ◽  
Anatomical Variation ◽  
Ulnar Artery ◽  
Predisposing Factor ◽  
Anatomical Structures ◽  
Pronator Teres ◽  
Flexor Carpi Ulnaris ◽  
Cubital Fossa ◽  
The Right ◽  
Flexor Digitorum

In this paper, we describe a very rare variant in the course of the ulnar artery that we encountered in dissecting the right upper limb of a 74-year-old man. The ulnar artery arose standardly from the brachial artery in the cubital fossa. However, its ensuing course differed from the norm. The artery entered together with the ulnar vein and median nerve into the pronator canal (between the humeral and ulnar heads of the pronator teres). Further, the ulnar artery descended classically to the ulnar side of the forearm between the flexor carpi ulnaris and flexor digitorum superficialis. Knowledge of this variation in the course of the ulnar artery may have significance in clinical practice because accumulation of anatomical structures in the pronator canal could be a predisposing factor for the compression of nerve or blood vessels. Keywords: anatomical variation; median nerve; pronator canal; pronator teres muscle; ulnar artery.  

scholarly journals INNERVATIONS OF PRONATOR TERES MUSCLE BY MEDIAN NERVE: A CADAVERIC STUDY

2020 ◽  
Vol 8 (2.2) ◽  
pp. 7470-7475
Author(s):  
Humera Shabbir Vantmuri ◽  
◽  
Uttama Umesh Joshi ◽  
Keyword(s):  
Median Nerve ◽  
Cadaveric Study ◽  
Pronator Teres

scholarly journals POSSIBLE ENTRAPMENT OF THE ULNAR ARTERY BY THE THIRD HEAD OF PRONATOR TERES MUSCLE. El posible atrapamiento de la arteria ulnar por el tercer fascículo del músculo pronador teres

2016 ◽  
Vol 4 (3) ◽  
pp. 102-105
Author(s):  
Naveen Kumar ◽  
Srinivasa Rao Sirasanagandla ◽  
Ashwini Aithal ◽  
Satheesha Nayak B
Keyword(s):  
Blood Pressure ◽  
Distal Part ◽  
Biceps Brachii ◽  
Ulnar Artery ◽  
Medical Practitioners ◽  
The Third ◽  
Pronator Teres ◽  
Orthopedic Surgeons ◽  
Brachialis Muscle ◽  
Cubital Fossa

El conocimiento de las variaciones en los alrededores de la fosa cubital es útil para cirujanos ortopédicos, cirujanos plásticos y médicos en general. Observamos las variaciones arteriales y musculares en y alrededor de la fosa cubital. La arteria braquial terminó 2 pulgadas por encima de la base de la fosa cubital. Las arterias radiales y cubitales entraron en la fosa cubital  pasando delante de los tendones de los músculos braquial y bíceps braquial respectivamente. La arteria cubital estaba rodeada por el tercer fascículo del pronador teres, que tuvo su origen en la fascia cubriendo la parte distal del músculo braquial. Este músculo se unió a tendón de pronador teres distalmente y fue suministrado por una rama del nervio mediano. Este músculo podría alterar el flujo sanguíneo en la arteria cubital y puede causar dificultades para el registro de la presión sanguínea. Knowledge of variations at and in the surroundings of cubital fossa is useful for the orthopedic surgeons, plastic surgeons and medical practitioners in general. During routine dissection, we observed arterial and muscular variations in and around the cubital fossa. The brachial artery terminated 2 inches above the base of the cubital fossa. The radial and ulnar arteries entered the cubital fossa by passing in front of the tendons of brachialis and biceps brachii respectively. The ulnar artery was surrounded by the third head of pronator teres which took its origin from the fascia covering the distal part of the brachialis muscle. This muscle joined pronator teres tendon distally and was supplied by a branch of median nerve. This muscle could alter the blood flow in the ulnar artery and may cause difficulties in recording the blood pressure.

scholarly journals Distal pronator teres motor branch transfer for wrist extension restoration in radial nerve paralysis

2020 ◽  
pp. 1-7
Author(s):  
Jayme Augusto Bertelli ◽  
Sushil Nehete ◽  
Elisa Cristiana Winkelmann Duarte ◽  
Neehar Patel ◽  
Marcos Flávio Ghizoni
Keyword(s):  
Median Nerve ◽  
Radial Nerve ◽  
Full Range ◽  
Medial Epicondyle ◽  
Wrist Extension ◽  
Motor Branch ◽  
Nerve Paralysis ◽  
Pronator Teres ◽  
Flexion Extension ◽  
Anterior Side

OBJECTIVEThe authors describe the anatomy of the motor branches of the pronator teres (PT) as it relates to transferring the nerve of the extensor carpi radialis brevis (ECRB) to restore wrist extension in patients with radial nerve paralysis. They describe their anatomical cadaveric findings and report the results of their nerve transfer technique in several patients followed for at least 24 months postoperatively.METHODSThe authors dissected both upper limbs of 16 fresh cadavers. In 6 patients undergoing nerve surgery on the elbow, they dissected the branches of the median nerve and confirmed their identity by electrical stimulation. Of these 6 patients, 5 had had a radial nerve injury lasting 7–12 months, underwent transfer of the distal PT motor branch to the ECRB, and were followed for at least 24 months.RESULTSThe PT was innervated by two branches: a proximal branch, arising at a distance between 0 and 40 mm distal to the medial epicondyle, responsible for PT superficial head innervation, and a distal motor branch, emerging from the anterior side of the median nerve at a distance between 25 and 60 mm distal to the medial epicondyle. The distal motor branch of the PT traveled approximately 30 mm along the anterior side of the median nerve; just before the median nerve passed between the PT heads, it bifurcated to innervate the deep head and distal part of the superficial head of the PT. In 30% of the cadaver limbs, the proximal and distal PT branches converged into a single trunk distal to the medial epicondyle, while they converged into a single branch proximal to it in 70% of the limbs. The proximal and distal motor branches of the PT and the nerve to the ECRB had an average of 646, 599, and 457 myelinated fibers, respectively.All patients recovered full range of wrist flexion-extension, grade M4 strength on the British Medical Research Council scale. Grasp strength recovery achieved almost 50% of the strength of the contralateral side. All patients could maintain their wrist in extension while performing grasp measurements.CONCLUSIONSThe distal PT motor branch is suitable for reinnervation of the ECRB in radial nerve paralysis, for as long as 7–12 months postinjury.

scholarly journals Bilateral high origin of terminal branches of brachial artery : a case report

2014 ◽  
Vol 03 (03) ◽  
pp. 162-165
Author(s):  
Amitav Sarma ◽  
Bishwajeet Saikia
Keyword(s):  
Case Report ◽  
Median Nerve ◽  
Brachial Artery ◽  
Clinical Importance ◽  
Main Trunk ◽  
Pronator Teres ◽  
Superficial Branch ◽  
Interosseous Artery ◽  
Cubital Fossa ◽  
Developmental Variations

AbstractA case of bilateral high termination of brachial artery was found during a cadaveric dissection at NEIGRIHMS, Meghalaya. The brachial artery of both arms in the upper 113rd divided into supericial and deep branches, the superficial artery was observed anteromedial and the deep artery posteromedial in relation to the median nerve. In the cubital fossa, the deep artery passed beneath the pronator teres muscle to give common interosseous artery which divided into anterior and posterior interosseous branches. The main trunk followed normal ulnar arterial course. In both the arms, the superficial branch of brachial artery remained lateral to the median nerve to reach the cubital fossa where it passed deep to the bicipital aponeurosis and descended just beneath the brachioradials muscle, following the normal course of radial artery. These developmental variations were thoroughly discussed and compared with previously published findings with their clinical importance.

scholarly journals A CADAVERIC STUDY ON THE ANATOMICAL VARIATIONS OF THE MUSCULOCUTANEOUS NERVE IN RELATION WITH MEDIAN NERVE AND CORACOBRACHIALIS MUSCLE

2018 ◽  
Vol 26 (2) ◽  
Author(s):  
Alok Tripathi ◽  
Hina Kausar ◽  
Saurabh Arora ◽  
Satyam Khare ◽  
Shilpi Jain ◽  
...  
Keyword(s):  
Median Nerve ◽  
Biceps Brachii ◽  
Axillary Artery ◽  
Anatomical Variations ◽  
Musculocutaneous Nerve ◽  
Cadaveric Study ◽  
Lateral Side ◽  
Medical College ◽  
Lateral Cord ◽  
Human Cadavers

Introduction: Musculocutaneous nerve is derived from the lateral cord of brachial plexus and supplies the muscles of the arm. Initially the nerve accompanies the lateral side of third part of axillary artery and then pierces the coracobrachialis muscle after supplying it, passes downwards and laterally in between biceps brachii and brachialis sending branches to both and continues as lateral cutaneous nerve of the forearm. Variations of musculocutaneous nerve is important for surgeons, orthopedic surgeons and traumatologists, so a detailed cadaveric study of musculocutaneous nerve was done to observe the variations. Material & Methods: Musculocutaneous nerve was studied in 50 human cadavers (30 males and 20 females) of age group 40-60 years at Department of Anatomy, Subharti Medical College, Meerut, India. Results: Musculocutaneous nerve was present in all the cases and was piercing the coracobrachialis muscle. In 4% of the cases, the nerve was rejoining the median nerve after piercing the coracobrachialis.

scholarly journals Two muscular variations in the elbow associated with the anterior interosseous nerve

2021 ◽  
Author(s):  
Łukasz Olewnik ◽  
Bartłomiej Szewczyk ◽  
Nicol Zielinska ◽  
Dariusz Grzelecki ◽  
Michał Polguj
Keyword(s):  
Biceps Brachii ◽  
Clinical Importance ◽  
Ulnar Artery ◽  
Flexor Pollicis Longus ◽  
Main Band ◽  
Anatomical Dissection ◽  
Pronator Teres ◽  
Anterior Interosseous Nerve ◽  
Male Cadaver ◽  
The Right

AbstractThe coexistence of different muscular-neurovascular variations is of significant clinical importance. A male cadaver, 76 years old at death, was subjected to routine anatomical dissection; the procedure was performed for research and teaching purposes at the Department of Anatomical Dissection and Donation, Medical University of Lodz. The right forearm and hand were dissected using standard techniques according to a strictly specified protocol. The presence accessory head of the flexor pollicis longus may potentially compress the anterior interosseous nerve. The present case report describes a rare variant of the ulnar head of the pronator teres, characterized by two independent bands (i.e., two proximal attachments). The main band originates from the coronoid process and the second originates from the tendon of the biceps brachii. This type of attachment could potentially affect the compression of the ulnar artery running between the two bands. Additionally, the accessory head of the flexor pollicis longus was observed, which started on the medial epicondyle; its coexistence with a high division median nerve creates a potential pressure site on the anterior interesosseous nerve.

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