Branch Of Posterior Interosseous Nerve Research Articles

Reconstruction of Digital Nerve Defects with Posterior Interosseous Nerve Terminal Joint Branch

Abstract Objective: The aim of our study is to retrospectively evaluate the patients who had digital nerve defective injuries of the hand which was reconstructed with the terminal branch of posterior interosseous nerve (PIN) for treatment. Methods: Twenty-three patients with digital nerve defective injuries, who applied late and were treated with PIN terminal branch grafting were included in the study. The mean age of the patients was 36.4 ± 8.1 years and the mean follow-up duration was 17.3 ± 3.2 months. The mean interval between the injury and the surgery was 5 (2-8) months, and the average gap in defective site was 19.7 ± 3.8 mm. Clinical assessment of the nerve healing was made with Semmes – Weinstein Monofilament (SWM) test and Static 2 Point Discrimination (S2PD) test and, the results were classified according to the British Medical Research Council (BMRC) scoring system. Results: The mean SMW test result was determined as 2.8 (2.8-20) grams, and the mean S2PD test result as 6 (4-20) mm at the sensory area of reconstructed nerve. Accordingly, BMRC scoring system revealed that sensory improvement was S4 level in 15 (65.2%) patients, S3 + in 4 (17.4%), S3 in 3 (13%) patients, and S2 level in 1 (4.3%) patient. Neuroma was not detected at any of the patients within the donor site. Scar formation was detected at 6 (26.1%) patients. Conclusion: PIN terminal branch is an appropriate substitute for digital nerve reconstruction with minimum morbidity and acceptable efficiency.

Transfer of the extensor indicis proprius branch of posterior interosseous nerve to reconstruct ulnar nerve and median nerve injured proximally: an anatomical study.

Proximal or middle lesions of the ulnar or median nerves are responsible for extensive loss of hand motor function. This occurs even when the most meticulous microsurgical techniques or nerve grafts are used. Previous studies had proposed that nerve transfer was more effective than nerve grafting for nerve repair. Our hypothesis is that transfer of the posterior interosseous nerve, which contains mainly motor fibers, to the ulnar or median nerve can innervate the intrinsic muscles of hands. The present study sought to investigate the feasibility of reconstruction of the deep branch of the ulnar nerve and the thenar branch of median nerve by transferring the extensor indicis proprius branch of the posterior interosseous nerve obtained from adult cadavers. The results suggested that the extensor indicis proprius branch of the posterior interosseous nerve had approximately similar diameters and number of fascicles and myelinated nerve fibers to those of the deep branch of ulnar nerve and the thenar branch of the median nerve. These confirm the feasibility of extensor indicis proprius branch of posterior interosseous nerve transfer for reconstruction of the deep branch of the ulnar nerve and the thenar branch of median nerve. This procedure could be a novel and effective method for the functional recovery of the intrinsic muscles of hands after ulnar nerve or median nerve injury.

Anatomic pattern of the terminal branches of posterior interosseous nerve

To understand the lesion of the terminal branches of posterior interosseous nerve (PIN), an anatomic study was carried out. Thirty adult cadaver arms were dissected and the anatomic pattern of the nerve was documented. The distance between the point at which the nerve divides into branches and the distal edge of the supinator were measured, as well as the length of each nerve branch to its muscle-entering sites. The number of branches innervating each muscle was recorded. It was found that the PIN was branching to multiple short branches and a single deep long branch after leaving the supinator muscle with great morphometric and schematic variances.

The terminal branch of posterior interosseous nerve: a useful donor for digital nerve grafting.

The anatomical relationships of the terminal branch of posterior interosseous nerve have been studied in 57 cadaver and amputation specimens. Removal of the nerve leaves the patient with no apparent sensory deficit. In all dissections the nerve was present and its location was constant. The mean obtainable length was 3.7 cm (range 2.7-5.1 cm) and its cross-sectional area made the nerve suitable for grafting of digital nerves.