Branches Of Medial Antebrachial Cutaneous Nerve Research Articles

Anatomie de la branche postérieure du nerf cutanée médial de l’avant bras — étude cadavérique

The posterior branch of the medial antebrachial cutaneous nerve (MACN) may be damaged during the cubital tunnel surgery. The purpose of this study was to identify the location of the posterior branch of the MACN. We performed an anatomical study on 20 limbs in 13 fresh cadavers. The nerve was dissected from 10 cm proximal to 10 cm distal to the medial epicondyle (ME). We measured the distance from the nerve to the medial epicondyle, and to the penetration of the ulnar nerve between the two heads of the flexor carpi ulnaris muscle. Measurements were performed on an elbow flexed at 45° and 90° as well as in pronation and supination. The posterior branch of the MACN exited the nerve and run anteriorly to the ME and then had an oblique direction toward the ulnar shaft. Average distances between the posterior branch of the MACN and the ME were 2.53 cm and 2.96 cm when the elbow was flexed at 45° and 90° respectively. Average distances between the posterior branch of the MACN and the crossing of the ulnar nerve with the flexor carpi ulnaris were 1.54 cm and 1.62 cm when the elbow was flexed at 45° and 90° respectively. The pronation and supination mobilizations did not significantly modify the measurements. Understanding the position of medial antebrachial cutaneous nerve branches during ulnar nerve release at the elbow may help to prevent iatrogenic injury to this cutaneous nerve. To prevent any nerve lesion, the incision and deep dissection should not be anterior to the medial epicondyle and be distal to the penetration of the ulnar nerve between both heads of the flexor carpi ulnaris nerve.

An Anatomical Basis for Endoscopic Cubital Tunnel Release and Associated Clinical Outcomes

To study the ulnar nerve in fresh-frozen cadavers as related to endoscopic release of the cubital tunnel and to present a retrospective review of patients treated with decompression via endoscopic visualization. To further our understanding of relevant anatomy, we dissected 26 cadaver limbs. We paid special attention to fascial membranes as potential sites of constriction as well as the position of nerves, vessels, and aberrant anatomy. These findings facilitated our understanding of the extent of release in 80 patients (92 cases) with endoscopic cubital tunnel simple decompression. Outcome measures included Disabilities of the Arm, Shoulder, and Hand score, Gabel and Amadio score, and grip and pinch strengths. We noted fascial bands proximal to the medial epicondyle in 12 of 26 cadaver specimens, 2 of which could be the so-called arcade of Struthers. We observed a high degree of variability in the anatomy of the flexor pronator aponeurosis distal to the medial epicondyle. Where present (n= 10), medial antebrachial cutaneous nerve branches crossed the ulnar nerve at an average distance of 2.9 cm from the medial epicondyle (range, 1.0-4.5 cm). Aberrant structures were noted in 8 of the 26 specimens, including an anconeus epitrochlearis muscle in 2 specimens, a basilic vein crossing the ulnar nerve in 4 specimens, and an accessory origin of the medial head of the triceps from the medial intermuscular septum in 2specimens. In the clinical portion of this study, the average Disabilities of the Arm, Shoulder, and Hand score before surgery was 49 (n= 34) and after surgery was 25 (n= 56). The Gabel and Amadio outcome scores were 24 excellent, 40 good, 25 fair, and 3 poor (n=92). Average follow-up was 8.2 months (range, 0.1-35 mo). Cadaveric dissections shed light on vulnerable anatomical structures during release, including branches of the medial antebrachial cutaneous nerve, ulnar nerve, brachial artery, fascial bands, and basilic vein. The high degree of anatomical variability in this study highlights the advantage of endoscopic visualization in allowing surgeons to minimize surgical trauma. Therapeutic IV.

Anatomical Distribution of Branches of the Medial Antebrachial Cutaneous Nerve during Cubital Tunnel Surgery

Purpose: The purpose of this prospective study is to examine the anatomical variations of the branches of the medial antebrachial cutaneous nerve in Koreans encountered during cubital tunnel surgery. Methods: Ninety two patients with cubital tunnel syndrome were treated with a standard approach from December 2008 to July 2012. The position of the branches of medial antebrachial cutaneous nerve was evaluated based on the medial humeral epicondyle with the elbows fully extended. Results: At least one medial antebrachial cutaneous nerve branch was found during the surgeries in all patients. The average number of crossing medial antebrachial cutaneous nerve branches per patient was 1.6. Thirty-eight percent of the cases showed that the medial cutaneous nerve branches cross proximal to the medial humeral epicondyle within 1 cm. Eighty-two percent showed that the medial antebrachial cutaneous nerve branches cross distal to the medial humeral epicondyle within 1.9 cm. Conclusion: When using standard approach during cubital tunnel surgery, more than one medial forearm cutaneous nerve is found. Therefore, understanding the general position of medial antebrachial cutaneous nerve branches helps avoid iatrogenic damage to this nerve during cubital tunnel surgery.

The position of crossing branches of the medial antebrachial cutaneous nerve during cubital tunnel surgery in humans.

The posterior branch of the medial antebrachial cutaneous nerve courses in proximity to the cubital tunnel and is particularly prone to injury during ulnar nerve release at the elbow. Inadvertent injury to medial antebrachial cutaneous nerve branches during surgery can result in the formation of painful neuromas that can be misdiagnosed as recurrent disease. It is important to understand the relevant anatomy of the medial antebrachial cutaneous nerve branches during cubital tunnel surgery to avoid significant postoperative morbidity. This prospective observational anatomic study examined the position of the posterior branch of the medial antebrachial cutaneous nerve in relationship to a standard approach to the cubital tunnel in a randomly selected group of 97 patients undergoing primary surgery over a 3-year period. Medial antebrachial cutaneous nerve branches were noted to cross at or proximal to the medial humeral epicondyle 61 percent of the time at an average proximal distance of 1.8 cm. Medial antebrachial cutaneous nerve branches were noted to cross distal to the medial humeral epicondyle 100 percent of the time at an average distal distance of 3.1 cm. Understanding the general position of crossing medial antebrachial cutaneous nerve branches during ulnar nerve release at the elbow may help to prevent iatrogenic injury to this cutaneous nerve.