Adnan Saithna1,2, Alison Longo3,4, R W Jordan5, Jeff Leiter3,6, Peter MacDonald3,6, Jason Old3,6. 1. Pan Am Clinic, 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada. adnan.saithna@nhs.net. 2. Department of Orthopaedic Surgery, Southport and Ormskirk Hospitals NHS Trust, Town Lane, Southport, PR8 6PN, UK. adnan.saithna@nhs.net. 3. Pan Am Clinic, 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada. 4. Department of Human Anatomy and Cell Science, College of Medicine, University of Manitoba, Winnipeg, Canada. 5. Department of Orthopaedic Surgery, Southport and Ormskirk Hospitals NHS Trust, Town Lane, Southport, PR8 6PN, UK. 6. Section of Orthopaedic Surgery, College of Medicine, University of Manitoba, Winnipeg, Canada.
Abstract
PURPOSE: To evaluate the risk of neurological injury from the placement of a bicortical guidewire during subpectoral biceps tenodesis. METHODS: Ten forequarter cadaver specimens were evaluated. A bicortical guidewire was placed, and measurements to important local neurological structures were made with digital calipers at open dissection. RESULTS: The mean (range, SD) distances from the guidewire to the respective nerves was as follows: axillary nerve posteriorly, 15.7 mm (10-22 mm, 3.4); axillary nerve laterally, 18.7 mm (12-27 mm, 4.3); radial nerve posteriorly, 26.2 mm (16-35 mm, 7.0); radial nerve medially, 25 mm (16-33 mm, 4.4); and musculocutaneous nerve, 20.1 mm (12-26 mm, 5.2). CONCLUSIONS: There has been some disagreement in the literature regarding the proximity of a bicortical guidewire to the axillary nerve posteriorly. The results of this study concur with reports from several other authors and demonstrate that this nerve is at risk of iatrogenic injury when using this technique. The clinical relevance of this work is to allow surgeons to better understand the proximity of the nerve to a bicortical guidewire and to highlight that this risk is avoided with a unicortical technique.
PURPOSE: To evaluate the risk of neurological injury from the placement of a bicortical guidewire during subpectoral biceps tenodesis. METHODS: Ten forequarter cadaver specimens were evaluated. A bicortical guidewire was placed, and measurements to important local neurological structures were made with digital calipers at open dissection. RESULTS: The mean (range, SD) distances from the guidewire to the respective nerves was as follows: axillary nerve posteriorly, 15.7 mm (10-22 mm, 3.4); axillary nerve laterally, 18.7 mm (12-27 mm, 4.3); radial nerve posteriorly, 26.2 mm (16-35 mm, 7.0); radial nerve medially, 25 mm (16-33 mm, 4.4); and musculocutaneous nerve, 20.1 mm (12-26 mm, 5.2). CONCLUSIONS: There has been some disagreement in the literature regarding the proximity of a bicortical guidewire to the axillary nerve posteriorly. The results of this study concur with reports from several other authors and demonstrate that this nerve is at risk of iatrogenic injury when using this technique. The clinical relevance of this work is to allow surgeons to better understand the proximity of the nerve to a bicortical guidewire and to highlight that this risk is avoided with a unicortical technique.
Authors: Paul M Sethi; Arun Rajaram; Knut Beitzel; Thomas R Hackett; David M Chowaniec; Augustus D Mazzocca Journal: J Shoulder Elbow Surg Date: 2012-06-26 Impact factor: 3.019
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Authors: Alexander Otto; Sebastian Siebenlist; Joshua B Baldino; Matthew Murphy; Lukas N Muench; Julian Mehl; Elifho Obopilwe; Mark P Cote; Andreas B Imhoff; Augustus D Mazzocca Journal: JSES Int Date: 2020-09-21