Year 2018, Volume 12, Issue 3, Pages 111 - 114 2018-12-31

Morphometry of the anterior interosseous nerve: a cadaveric study

Sibel Kibar [1] , Burak Bilecenoğlu [2] , Luis Filgueira [3] , Aysun Uz [4]

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Objectives: ​Pathophysiology and etiology of anterior interosseous nerve (AIN) syndrome are still controversial. This anatomical​ ​dissection study aimed to understand the anatomy of AIN.

Methods: From a random sample of upper extremities of whole-body human cadavers (n=10), 20 upper extremities were included​ ​in the study. Two of the cadavers were females and 8 were males (age range 34–62 years). Specimens were dissected with​ ​the elbow in extension, wrist in neutral position and forearm in pronation. After superficial dissection, the pronator teres muscle​ ​was released, and the branching pattern of the AIN and the separation of the nerve from the interepicondylar line were​ ​recorded. The branches to the pronator teres, flexor pollicis longus, flexor digitorum profundus and flexor digitorum superficialis​ ​were recorded according to their distance from the interepicondylar line.

Results: The AIN branched from the main trunk 5.1 to 47.89 mm (mean 37.58±11.25 mm) distal to the interepicondylar line.​ ​AIN gave off 1–4 branches to the pronator teres. The first branch left the AIN 10.05–83.84 mm proximal and entered the muscle​ ​23.49–43.72 mm distal to the interepicondylar line. AIN gave 1–4 branches to the flexor pollicis longus, flexor digitorum profundus​ ​and flexor digitorum superficialis at varying distances. The origin of the branches of AIN, as well as the innervation by​ ​one or multiple branches for a muscle, was variable.

Conclusion: This study provides a detailed map of the anterior interosseous nerve innervating flexor pollicis longus, flexor​ ​digitorum profundus and flexor digitorum superficialis muscles, to serve as a guide for location of AIN block in patients with​ ​upper extremity spasticity and AIN syndrome.


 



anterior interosseous nerve, cadaver, morphometry
  • 1- Bilecenoğlu B, Uz A, Karalezli N. Possible anatomic structures causing entrapment neuropathies of the median nerve: an anatomic study. Acta Orthop Belg. 2005;71(2):169-762- Roy J, Henry BM, Pękala PA, Vikse J, Ramakrishnan PK, Walocha JA, Tomaszewski KA. The prevalence and anatomical characteristics of the accessory head of the flexor pollicis longus muscle: a meta-analysis. Peer J. 2015 Oct 1;3:e1255. doi: 10.7717/peerj.1255.3- Maldonado AA, Amrami KK, Mauermann ML, Spinner RJ. Reinterpretation of Electrodiagnostic Studies and Magnetic Resonance Imaging Scans in Patients with Nontraumatic "Isolated" Anterior Interosseous Nerve Palsy. Plast Reconstr Surg. 2016 Nov;138(5):1033-1039.4- Dunn AJ, Salonen DC, Anastakis DJ. MR imaging findings of anterior interosseous nerve lesions. Skeletal Radiol. 2007 Dec;36(12):1155-62.5- Gaitzsch G, Chamay A. Paralytic brachial neuritis or Parsonage-Turner syndrome anterior interosseous nerve involvement. Report of three cases. Ann Chir Main. 1986;5(4):288-946- Rennels GD, Ochoa J. Neuralgic amyotrophy manifesting as anterior interosseous nerve palsy. Muscle Nerve. 1980 Mar-Apr;3(2):160-47- Kim MY1, Kim DH, Park BK, Kim BH. Pseudo-anterior interosseous nerve syndrome by multiple intramuscular injection. Ann Rehabil Med. 2013 Feb;37(1):138-42. doi: 10.5535/arm.2013.37.1.138.8- Wertsch JJ. AAEM case report #25: anterior interosseous nerve syndrome. Muscle Nerve. 1992 Sep;15(9):977-83.9- Rodner CM, Tinsley BA, O'Malley MP. Pronator syndrome and anterior interosseous nerve syndrome. J Am Acad Orthop Surg. 2013 May;21(5):268-75. doi: 10.5435/JAAOS-21-05-268. Review.10- Lubahn JD, Cermak MB. Uncommon nerve compression syndromes of the upper extremity. J Am Acad Orthop Surg. 1998 Nov-Dec;6(6):378-86.11- Alexandre A1, Alexandre AM, Zalaffi A. Considerations on the treatment of anterior interosseous nerve syndrome. Acta Neurochir Suppl. 2011;108:247-50. doi: 10.1007/978-3-211-99370-5_38.12- Eker HE, Cok OY, Aribogan A, Arslan G. Management of neuropathic pain with methylprednisolone at the site of nerve injury. Pain Med. 2012 Mar;13(3):443-51. doi: 10.1111/j.1526-4637.2011.01323.x.13- Morris HH, Peters BH. Pronator syndrome: clinical and electrophysiological features in seven cases. J Neurol Neurosurg Psychiatry. 1976 May;39(5):461-4.14- Grutter PW1, Desilva GL, Meehan RE, Desilva SP. The accuracy of distal posterior interosseous and anterior interosseous nerve injection. J Hand Surg Am. 2004 Sep;29(5):865-70.15- Alfaro, A. Anterior interosseus nerve blocks to treat finger flexor muscle spasticity . Muscle & nerve.2012; 46(4):645-645 16- Yang F, Zhang X, Xie X, Yang S, Xu Y, Xie P. Intramuscular nerve distribution patterns of anterior forearm muscles in children: a guide for botulinum toxin injection. Am J Transl Res. 2016 Dec 15;8(12):5485-5493.17- Lepage D1, Parratte B, Tatu L, Vuiller F, Monnier G. Extra- and intramuscular nerve supply of the muscles of the anterior antebrachial compartment: applications for selective neurotomy and for botulinum toxin injection. Surg Radiol Anat. 2005 Dec;27(5):420-30.18- Bilecenoglu B1, Uz A, Karalezli N, Issi S. Two anatomic variations in the arm related to the median nerve. Saudi Med J. 2005 Nov;26(11):1827-8.19- MC Namara B. Clinical Anatomy of Median Nerve . Anatomy Primer. ACNR Volume 2 Number 6 January/ February 2003. Page 19,2020- Vincelet Y, Journeau P, Popkov D, Haumont T, Lascombes P. The anatomical basis for anterior interosseous nerve palsy secondary to supracondylar humerus fractures in children. Orthop Traumatol Surg Res. 2013 Sep;99(5):543-7. doi: 10.1016/j.otsr.2013.04.002.21-Canovas F, Mouilleron P, Bonnel F. Biometry of the muscular branches of the median nerve to the forearm. Clin Anat. 1998;11(4):239-45.22- Sunderland S. The intraneural topography of the radial, median and ulnar nerves. Brain 1945;68:243—99.
Primary Language en
Subjects Health Care Sciences and Services
Journal Section Original Articles
Authors

Orcid: 0000-0002-9967-7809
Author: Sibel Kibar (Primary Author)
Institution: Department of Anatomy, Ankara University School of Medicine, Ankara, Turkey
Country: Turkey


Author: Burak Bilecenoğlu
Institution: Department of Anatomy, Ankara University Faculty of Dentistry, Ankara, Turkey
Country: Turkey


Author: Luis Filgueira
Institution: Department of Anatomy, University of Fribourg, Fribourg, Switzerland
Country: Switzerland


Author: Aysun Uz
Institution: Department of Anatomy, Ankara University School of Medicine, Ankara, Turkey
Country: Turkey


Bibtex @research article { anatomy516292, journal = {Anatomy}, issn = {1307-8798}, eissn = {1308-8459}, address = {Turkish Society of Anatomy and Clinical Anatomy (TSACA)}, year = {2018}, volume = {12}, pages = {111 - 114}, doi = {}, title = {Morphometry of the anterior interosseous nerve: a cadaveric study}, key = {cite}, author = {Kibar, Sibel and Bilecenoğlu, Burak and Filgueira, Luis and Uz, Aysun} }
APA Kibar, S , Bilecenoğlu, B , Filgueira, L , Uz, A . (2018). Morphometry of the anterior interosseous nerve: a cadaveric study. Anatomy, 12 (3), 111-114. Retrieved from http://dergipark.org.tr/anatomy/issue/44861/516292
MLA Kibar, S , Bilecenoğlu, B , Filgueira, L , Uz, A . "Morphometry of the anterior interosseous nerve: a cadaveric study". Anatomy 12 (2018): 111-114 <http://dergipark.org.tr/anatomy/issue/44861/516292>
Chicago Kibar, S , Bilecenoğlu, B , Filgueira, L , Uz, A . "Morphometry of the anterior interosseous nerve: a cadaveric study". Anatomy 12 (2018): 111-114
RIS TY - JOUR T1 - Morphometry of the anterior interosseous nerve: a cadaveric study AU - Sibel Kibar , Burak Bilecenoğlu , Luis Filgueira , Aysun Uz Y1 - 2018 PY - 2018 N1 - DO - T2 - Anatomy JF - Journal JO - JOR SP - 111 EP - 114 VL - 12 IS - 3 SN - 1307-8798-1308-8459 M3 - UR - Y2 - 2019 ER -
EndNote %0 Anatomy Morphometry of the anterior interosseous nerve: a cadaveric study %A Sibel Kibar , Burak Bilecenoğlu , Luis Filgueira , Aysun Uz %T Morphometry of the anterior interosseous nerve: a cadaveric study %D 2018 %J Anatomy %P 1307-8798-1308-8459 %V 12 %N 3 %R %U
ISNAD Kibar, Sibel , Bilecenoğlu, Burak , Filgueira, Luis , Uz, Aysun . "Morphometry of the anterior interosseous nerve: a cadaveric study". Anatomy 12 / 3 (December 2019): 111-114.