Dissection Study of the Innervation of the Anterior Elbow Joint: Laying the Anatomical Foundation for Minimally Invasive Pain Relief Procedures to Treat Elbow Joint Pain.

Abstract

Translate Article

Take Notes

Minimally invasive pain relief treatments targeting articular nerves have emerged as treatment options for chronic joint pain, bridging the gap between conservative management and surgical intervention. These procedures have not been developed for the elbow joint due to insufficient anatomical knowledge of the articular branches innervating the elbow joint. To determine origin, course, frequency, landmarks and capsular distribution of the articular branches supplying the anterior elbow joint. Anatomical dissection study. 6 upper extremity specimens were meticulously dissected. Articular branches were traced from their origin on the brachial plexus to their termination. Origin, course, termination, and landmarks of each branch were documented and photographed in high-resolution. A frequency map was generated to visualize the capsular areas supplied by each articular branch. The musculocutaneous and/or median nerve gave rise to an extramuscular branch supplying the capsule deep to brachialis (83%). The median nerve supplied the medial capsule via a direct articular branch (17%), branches to flexor digitorum superficialis (100%), and a branch to pronator teres (67%). The anterior interosseus nerve supplied the capsule over the proximal radioulnar joint (67%). The radial nerve provided articular innervation to the lateral capsule via a radial branch to brachialis (83%), branches to extensor carpi radialis longus (100%), and branches to supinator (100%). Detailed anatomical knowledge of the articular branches supplying the anterior elbow joint is essential for identifying potential targets for therapeutic intervention and exploring selective blockade of articular nerves to alleviate pain originating from specific capsular areas.