Supinator motor branch transfer to the posterior interosseous nerve in C7-T1 brachial plexus palsies: an anatomical study

Abstract

Objective To investigate the anatomical feasibility of transferring the supinator motor branches to the posterior interosseous nerve in treating C7-T1 brachial plexus palsies and to explore the optimal surgical approach of this technique. Methods The branches of the radial nerve distal to the elbow were dissected in 13 formalin-embalmed forearms.Branching pattern,distribution and diameter of the supinator motor branches and the posterior interosseous nerve were recorded and measured. Results Most frequently,three supinator motor branches were observed,among which two were located proximal to the arcade of Frohse (the proximal margin of supinator muscle) and one branch laid within the supinator tunnel.The two extra-tunnel branches were anatomically constant and could be directly coapted with the posterior interosseous nerve.Conclusion It is anatomically feasible to transfer the supinator motor branches directly to the posterior interosseous nerve to restore thumb and finger extension in patients with C7-T1 brachial plexus palsies. Key words: Radial nerve; Brachial plexus; Supinator; Muscle branch; Posterior interosseous nerve