Cadaveric study of anatomical variations of the radial nerve and its clinical significance

Abstract

Background/Aim. The radial nerve is the largest terminal branch of the posterior cord of the brachial plexus. Upon leaving the axilla, it moves to the posterior compartment of the arm, where it makes close contact with the humerus. By penetrating the lateral intermuscular septum, it enters the anterior compartment, and in the very proximity of the lateral epicondyle, it divides into two terminal branches. This nerve is characterised by remarkable variability, the knowledge of which is of utmost importance in the fields of orthopaedics and traumatology. The aim of the study was to examine the radial nerve, including two parameters: the location and the way of termination, with a particular emphasis on the clinical implications. Methods. Research was conducted on 54 upper extremities. After careful dissection, variations in the location and way of termination of the radial nerve were observed on both the right and left hands. Collected data were then analysed using Microsoft Office Excel. Results. According to the proposed classification of the location of the radial nerve termination into types A and B, we observed the higher incidence of type A (64.8%) compared to type B (35.2%). In addition, we observed twice the percentage of type B in women compared to men. There were differences in the distribution of types A and B between the left and right arms, but there were no variations in the way of termination of the radial nerve. Conclusion. The present study showed an important complexity in the domain of radial nerve anatomy with significant clinical implications. With that in mind, it is crucial for every patient that the limits of safe zones be defined while performing surgical procedures in the elbow to protect the radial nerve and its branches from iatrogenic injuries.