Academic Journal
Risk of Injury to the Superficial Branch of the Radial Nerve in Dorsal and Anterolateral Approaches to the First Carpometacarpal Joint.
| Τίτλος: | Risk of Injury to the Superficial Branch of the Radial Nerve in Dorsal and Anterolateral Approaches to the First Carpometacarpal Joint. |
|---|---|
| Συγγραφείς: | Pérez de Gracia-Velázquez I; Granada University, Spain., De Torres-Urrea J; Mediterráneo Hospital, Almeria, Spain., Roda O; Granada University, Spain., Simón-Pérez C; Valladolid University, Spain.; University Hospital of Valladolid, Spain., Martín-Morales N; Granada University, Spain.; Instituto de Investigación Biosanitaria (IBS), Granada, Spain., O'Valle F; Granada University, Spain.; Instituto de Investigación Biosanitaria (IBS), Granada, Spain., Hernández-Cortés P; Granada University, Spain.; Instituto de Investigación Biosanitaria (IBS), Granada, Spain.; University Hospital of Granada, Spain. |
| Πηγή: | Hand (New York, N.Y.) [Hand (N Y)] 2026 Oct; Vol. 21 (9), pp. 1439-1446. Date of Electronic Publication: 2025 Dec 17. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: SAGE Publications Country of Publication: United States NLM ID: 101264149 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1558-9455 (Electronic) Linking ISSN: 15589447 NLM ISO Abbreviation: Hand (N Y) Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2016- : Thousand Oaks, CA : SAGE Publications Original Publication: New York, N.Y. : Springer, c2006- |
| Ιατρικοί όροι (MeSH): | Carpometacarpal Joints*/surgery , Carpometacarpal Joints*/innervation , Radial Nerve*/injuries , Radial Nerve*/anatomy & histology , Peripheral Nerve Injuries*/etiology, Thumb/surgery ; Thumb/innervation ; Osteoarthritis/surgery ; Humans ; Cadaver ; Female ; Male ; Aged |
| Περίληψη: | Background: Complications of thumb basal joint arthritis surgery include surgical wound pain and cheiralgia paresthetica through involvement of the radial nerve superficial branch (RNSB). The aim of this study is to compare the risk of nerve injury between anterolateral and dorsal approaches to the first carpometacarpal joint (1CMCJ) by measuring the distance between the incisions and RNSB, recording crosses between them, and evaluating the density of skin nerve endings at incision sites. Methods: In this descriptive study of 20 cryopreserved cadaver specimens, the anatomical distribution of the RNSB and its relationship with 1CMCJ anterolateral and dorsal approaches were determined by macro-dissection, and histomorphological analysis and digital imaging were used to measure cutaneous nerve ending density at the 1CMCJ and incision sites. Results: In comparison to dorsal approach, the minimum distance from the RNSB was significantly shorter (1.30 ± 1.94 mm vs 3.70 ± 2.71 mm), and the total number (16.60 ± 8.50 vs 9.97 ± 7.51) and density (2.00 ± 0.83 vs 1.29 ± 0.77 mm2) of nerve endings were significantly higher with anterolateral approach. With the anterolateral approach, more nerve structures were observed in the distal versus proximal section of the incision, although the difference was only close-to-significant. Conclusion: The incision is closer to the RNSB pathway with Wagner's anterolateral approach than with Gervis' dorsal approach, crossing with nerve branches in 50% of cases. The density of nerves is higher in the skin overlying the anterolateral versus dorsal aspect of the carpometacarpal joint. The risk of neuropathic wound pain after 1CMCJ surgery could be higher with the anterolateral approach, which should therefore be avoided. |
| Competing Interests: | Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Contributed Indexing: | Keywords: nerve ending density; superficial branch of the radial nerve; surgical approach; surgical wound; trapeziometacarpal osteoarthritis; trapeziometacarpal prosthesis |
| Entry Date(s): | Date Created: 20251217 Date Completed: 20260912 Latest Revision: 20260912 |
| Update Code: | 20260913 |
| PubMed Central ID: | PMC12711530 |
| DOI: | 10.1177/15589447251392940 |
| PMID: | 41405539 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1558-9455 |
|---|---|
| DOI: | 10.1177/15589447251392940 |