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Anatomical Basis for Injection around First Dorsal Compartment of the Wrist: A Fresh Cadaveric Study

Authors
Cheong, In YaeRhyu, Im JooKim, Ki HoonChung, Phil WooKim, DasomPark, Byung KyuKim, Dong Hwee
Issue Date
Aug-2016
Publisher
AM SOC INTERVENTIONAL PAIN PHYSICIANS
Keywords
Superficial radial nerve, abductor pollicis longus, extensor pollicis brevis, cadaver; wrist, first dorsal compartment
Citation
PAIN PHYSICIAN, v.19, no.6, pp E893 - E900
Indexed
SCIE
SCOPUS
Journal Title
PAIN PHYSICIAN
Volume
19
Number
6
Start Page
E893
End Page
E900
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/6197
ISSN
1533-3159
2150-1149
Abstract
Background: It is important to understand the anatomical relationship between the medial and lateral branches of superficial radial nerve (SRN) and the first dorsal compartment to prevent and minimize possible injury to these nerves during various procedures around the tip of radial styloid process (RSP). Objective: To delineate the anatomical location of the SRN in relation to the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons. Study Design: Observational study. Setting: Academic medical center. Methods: The width of the first dorsal compartment, distance between the EPB tendon and the closest medial branch of the SRN, and distance between the APL tendon and the closest lateral branch of the SRN were measured. The distances were measured at the RSP (the tip of the RSP) and RSP+1 (1 cm proximal to the tip of the RSP) levels. Results: The median distances between the EPB tendon and the closest medial branch of the SRN at the RSP and RSP+1 were 6.0 mm (range: 1.6 - 11.0 mm) and 3.2 mm (range: -2.0 - 9.4 mm), respectively. The median distances from the APL tendon to the closest lateral branch of the SRN at the RSP and RSP+1 were -2.0 mm (range: -9.0 - 8.4 mm) and 1.0 mm (range: -7.2 - 8.0 mm), respectively. A high percentage of overlap (up to 59%) was observed between the lateral branch of the SRN and the APL tendon. Limitation: This study is limited by its small sample size. Conclusion: Due to the anatomical proximity of the branches of the SRN and the first dorsal compartment around the RSP, physicians must be cautious during procedures near this location. It is important to approach from above the EPB, rather than from above the APL, when performing blind procedures, although ultrasound guidance is preferable.
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2. Clinical Science > Department of Physical Medicine and Rehabilitation > 1. Journal Articles
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College of Medicine (Department of Anatomy)
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