Safe Posterolateral Approach for Proximal Radial Surgery Determined by Dynamic Ultrasound

Proximal radial surgery requires a detailed knowledge of the region of the posterior interosseous nerve (PIN) because of the risk of injury. The posterolateral approach to the elbow described by Kocher is a common surgical exposure. The purpose of this study was to determine the dimensions of a surgically safe zone along the proximal part of the radius from the posterolateral approach using dynamic ultrasound. Data from 62 individual upper extremities were collected, and the relationship of the PIN to the radius was examined to determine the change in position associated with forearm motion. The distance from the radial head to the point where the PIN crossed the dorsal aspect of the radius was measured with the forearm in pronation and in supination. With the forearm in full supination, the PIN crossed the midpoint of the long axis of the radius at a mean ± SD of 54.5±5.7 mm (range, 45-68 mm) from the radial head. With the forearm in full pronation, this distance decreased to a mean of 42.5±6.5 mm (range, 32-60 mm). Flexion and extension of the elbow had no effect on these distances. The mean radial length was 24.20±1.36 cm (range, 20.8-27.6 cm). The results of our study indicated that, contrary to the recommendations of previous authors, posterolateral approaches to the proximal part of the radius are safer in supination.

並列關鍵字

posterior interosseous nerve ； proximal radius ； position

國際替代計量

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