Ultrasound Investigation of the Radial Nerve's Superficial Branch: Reducing the Risk of K-Wire Insertion Damage in Distal Radius Fractures.
Hand (N Y)
; : 15589447231196903, 2023 Sep 14.
Article
em En
| MEDLINE
| ID: mdl-37706443
ABSTRACT
BACKGROUND:
Kirschner wire (K-wire) insertion during surgery for distal radius fractures carries a risk of damaging the radial nerve's superficial branch. In this prospective study, we investigated the relationship between the radial nerve's superficial branch and the radius using ultrasound to minimize risk.METHODS:
We collected data from 101 healthy volunteers (202 limbs; 51 men; mean age 40.6 years). We ultrasonographically assessed the courses of the radial nerve's dorsal and superficial palmar branches at 0, 1, 2, and 3 cm proximal to the radial styloid process tip. The positional relationship between the radial nerve's superficial branch and the radius was determined by splitting the radius's ultrasound map into 4 sections (R1-R4) from the palmar side. The section containing the dorsal and palmar branch midpoints was determined for each height.RESULTS:
In many limbs, the dorsal branch tended to wrap from the proximal palmar to the distal dorsal side at 1 to 2 cm proximal to the radial styloid process tip. In approximately 90% of limbs, the palmar branch ran along the radius's palmar side rather than the radial surface.CONCLUSIONS:
A small incision enabling direct view may be the best approach for avoiding nerve damage when the superficial branch is less than or equal to 2 cm proximal to the tip of the radial styloid process. Inserting the K-wire from the dorsal side of the radius may be safer for more proximal locations. We recommend a preoperative ultrasound examination to determine the course of the superficial branches of the radial nerve in each patient.
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Base de dados:
MEDLINE
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Hand (N Y)
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Japão