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A morphometric study of the palmar cutaneous branch of the median nerve: is there a risk of injury when volar plate fixation is used for the treatment of distal radial fractures?

A morphometric study of the palmar cutaneous branch of the median nerve: is there a risk of injury when volar plate fixation is used for the treatment of distal radial fractures?
A morphometric study of the palmar cutaneous branch of the median nerve: is there a risk of injury when volar plate fixation is used for the treatment of distal radial fractures?
Volar plating of distal radius fractures has recently gained favour due to complications associated with external fixation and dorsal plating techniques. The aim of this study was to determine the impact of the incision made in volar fixation on the palmar cutaneous branch of the median nerve (PCBMN). A standard Henry's approach was applied to 10 pairs of human cadaver hands. Further dissection was undertaken to provide morphometric data. The PCBMN was not damaged by the incision in any of the specimens and was absent in two specimens. Mean distances from the origin of the PCBMN to the distal wrist crease (DWC), scaphoid tubercle (ST) and bistyloid line (BSL) were 55.15, 76.04, and 52.38 mm, respectively. From the flexor carpi radialis tendon, ST and radial styloid process the mean distances to the PCBMN were 4.46, 22.82, and 29.07 mm, respectively. The nerve entered the flexor retinaculum at a mean of 10.88, 22.73, and 10.69 mm from the BSL, ST and DWC, respectively. Measurement reliability ranged from ICC 0.98 to 1.00 (intra-observer) and 0.96 to 1.00 (inter-observer). These findings suggest that damage to the PCBMN from this technique is unlikely but knowledge of variants can help minimize the risk of injury.
0897-3806
393
Richards, O.
593d9784-adbf-4385-96e3-39db09e3dbcf
O'Sullivan, E.
400be0c4-e2b2-49d4-a7f6-fc3d20cd224b
Border, S.
67fce2e0-d2cd-43a2-a9cc-e6cb6fd28544
Webb, A.
9618983d-c2dd-4a04-9890-4abf615f0221
Richards, O.
593d9784-adbf-4385-96e3-39db09e3dbcf
O'Sullivan, E.
400be0c4-e2b2-49d4-a7f6-fc3d20cd224b
Border, S.
67fce2e0-d2cd-43a2-a9cc-e6cb6fd28544
Webb, A.
9618983d-c2dd-4a04-9890-4abf615f0221

Richards, O., O'Sullivan, E., Border, S. and Webb, A. (2011) A morphometric study of the palmar cutaneous branch of the median nerve: is there a risk of injury when volar plate fixation is used for the treatment of distal radial fractures? [in special issue: Abstracts Presented at the Summer Meeting of the British Association of Clinical Anatomists, Laboratory of Human Anatomy, University of Glasgow, Glasgow, United Kingdom from 21st to 22nd of July, 2010] Clinical Anatomy, 24 (3), 393. (doi:10.1002/ca.21162).

Record type: Article

Abstract

Volar plating of distal radius fractures has recently gained favour due to complications associated with external fixation and dorsal plating techniques. The aim of this study was to determine the impact of the incision made in volar fixation on the palmar cutaneous branch of the median nerve (PCBMN). A standard Henry's approach was applied to 10 pairs of human cadaver hands. Further dissection was undertaken to provide morphometric data. The PCBMN was not damaged by the incision in any of the specimens and was absent in two specimens. Mean distances from the origin of the PCBMN to the distal wrist crease (DWC), scaphoid tubercle (ST) and bistyloid line (BSL) were 55.15, 76.04, and 52.38 mm, respectively. From the flexor carpi radialis tendon, ST and radial styloid process the mean distances to the PCBMN were 4.46, 22.82, and 29.07 mm, respectively. The nerve entered the flexor retinaculum at a mean of 10.88, 22.73, and 10.69 mm from the BSL, ST and DWC, respectively. Measurement reliability ranged from ICC 0.98 to 1.00 (intra-observer) and 0.96 to 1.00 (inter-observer). These findings suggest that damage to the PCBMN from this technique is unlikely but knowledge of variants can help minimize the risk of injury.

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Published date: March 2011
Organisations: Medical Education

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Local EPrints ID: 366830
URI: http://eprints.soton.ac.uk/id/eprint/366830
ISSN: 0897-3806
PURE UUID: 5ae68e2d-7930-4ebd-91f0-62b29b035892

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Date deposited: 14 Jul 2014 11:55
Last modified: 10 Jul 2020 16:34

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