Anatomical Feasibility Study of Superficial Branch of Radial Sensory Nerve Transfer to Sensory Branch of Ulnar Nerve in Lower Arm Type of Brachial Plexus Injury

Authors

  • K Supichyangur Orthopaedic Department, Rajavithi Hospital
  • C Pholprasert Orthopaedic Department, Rajavithi Hospital
  • K Chayaburakul Orthopaedic Department, Rajavithi Hospital

Keywords:

Superficial branch of radial sensory nerve, Sensory branch of ulnar nerve, Brachial plexus injury, Neurotization or nerve transfer

Abstract

Background : Patients who were diagnosed with C7-T1 brachial plexus injury lost sensation in the area which was supplied by the sensory branch of the ulnar nerve. Neurotization or nerve transfer of the radial branch of the superficial radial nerve (RSRN) to the sensory branch of the ulnar nerve would provide the protective sensation method in these group of patients.

Objectives : To study the feasibility in transferring the RSRN to the sensory branch of the ulnar nerve by studying the relationship between the arm length, nerves and branches of the superficial radial nerve (SBRN), in both male and female.

Methods : To study 80 cadaver´s forearms, measuring arm length, the RSRN and the sensory branch of the ulnar nerve. Studying the number of SBRN branches and a suitable surgery procedure of nerve transfer surgery for both male and female by defining a clear reference point. The measurements were measured by the physician with intra-observer reliability test ICC>0.9.

Results : The arm length was significantly related to the sensory branch of the ulnar nerve (p = 0.001) but there was no significant change relating to the radial nerve (RSRN) (p = 0.439). The SBRN from both male and female had two branches and were suitable for the surgical procedure.

Conclusions : Nerve transfer of the radial branch of the superficial radial nerve (RSRN) to the sensory branch of the ulnar nerve was feasible, with no tension at the suture point. We found every cadaver had two branches of the superficial radial nerve (SBRN), with possible minor donor site deficit because it was compensated by the ulnar branch of the superficial radial nerve and median nerve.

References

Polatsch DB, Melone CP Jr, Beldner S, Incorvaia A. Ulnar nerve anatomy. Hand Clin 2007; 23:283–9.

Agur AMR, Dalley AF. Grant’s Atlas of anatomy. 13th ed. Baltimore: Lippincott Williams & Wilkins; 2013.

Thompson JC. Netter’s concise orthopaedic anatomy. 2nd ed. Philadelphia: Saunders Elsevier; 2010.

Xu B, Dong Z, Zhang CG, Gu YD. Transfer of the radial branch of the superficial radial nerve to the sensory branch of the ulnar nerve for sensory restoration after C7-T1 brachial plexus injury. J Plast Reconstr Aesthet Surg 2016; 69:318-22.

Shafi M, Hattori Y, Doi K. Surgical technique of harvesting vascularized superficial radial nerve graft. J Hand Surg Am 2010; 35:312-5.

Samarakoon LB, Lakmal KC, Thillainathan S, Bataduwaarachchi VR, Anthony DJ, Jayasekara RW. Anatomical relations of the superficial sensory branches of the radial nerve: a cadaveric study with clinical implications. Patient Saf Surg 2011; 5:28.

Wayne WD. Biostatistics: A foundation of analysis in the health sciences. 6th ed. New York: John Wiley and Sons; 1995.

Spinner RJ, Shin AY, Elhassan BT, Bishop AT. Traumatic brachial plexus injury. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS, editors. Green’s operative hand surgery. 7th ed. Philadelphia: Elsevier; 2017. P. 1146-204.

Robson AJ, See MS, Ellis H. Applied anatomy of the superficial branch of the radial nerve. Clin Anat 2008; 21:38-45.

Gurses IA, Coskun O, Gayretli O, Kale A, Ozturk A. The relationship of the superficial radial nerve and its branch to the thumb to the first extensor compartment. J Hand Surg Am 2014; 39:480-3.

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Published

30-03-2020

How to Cite

1.
Supichyangur K, Pholprasert C, Chayaburakul K. Anatomical Feasibility Study of Superficial Branch of Radial Sensory Nerve Transfer to Sensory Branch of Ulnar Nerve in Lower Arm Type of Brachial Plexus Injury. J DMS [Internet]. 2020 Mar. 30 [cited 2024 Mar. 28];45(1):35-41. Available from: https://he02.tci-thaijo.org/index.php/JDMS/article/view/244739

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Original Article