Posterior interosseous nerve: an anatomic study of potential nerve grafts.

Anatomic dissection of the posterior interosseous nerve in 26 cadaver forearms was performed to assess variability in location, diameter, and branching patterns of the nerve. The purpose of our study was to determine the anatomic reliability of the posterior interosseous nerve at the distal forearm level as a potential donor nerve graft for segmental digital nerve loss. The nerve was located in a separate fascicle sheath in the deep radial aspect at the fourth dorsal compartment in all specimens. It ranged from 1 to 5 mm in diameter with one to five fascicles present (15 of 26 specimens had a single fascicle). Ten additional specimens were dissected for assessment of potential length of nerve available for grafting, and this ranged from 5 to 10 cm. These nerves were believed to be of sufficient diameter for grafting of digital-level nerve injuries. There is minimal morbidity when a donor graft is obtained in the same limb as the recipient area, and there is no known donor deficit as a result of posterior interosseous nerve procurement at wrist level.