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ORIGINAL ARTICLES
Published online: 2020-03-03
Submitted: 2020-01-02
Accepted: 2020-02-11
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Assessing the innervation of the dorsal wrist capsule using modified Sihler’s staining

T. Bonczar, J. A. Walocha, M. Bonczar, E. Mizia, J. Filipowska
DOI: 10.5603/FM.a2020.0027
·
Pubmed: 32159843

open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2020-03-03
Submitted: 2020-01-02
Accepted: 2020-02-11

Abstract

Background: The aim of this study was to assess the innervation of the dorsal articular capsule of the wrist using modified Sihler’s staining. Materials and methods: Thirty dorsal wrist capsules were collected from 15 donors (both sides) within 12 hours of death. All the capsules were collected in the same manner – using the dorsal incision. The specimens were stained according to the protocol of the modified Sihler’s staining technique. The preserved capsules were analyzed under 8-16× magnification of an optical microscope for the presence of major nerve trunks, their major and minor branches, and nerve connections. Results: The range of innervation visualized was that the posterior interosseous nerve innervated approximately 60% of the central part; the remaining area was innervated by the dorsal sensory branch of the radial nerve and medial antebrachial cutaneous nerve. The constant findings were the branches departing from the ulnar side of the posterior interosseous nerve and from the radial side, with an exception seen in two cases. A communicans branch between the posterior interosseous nerve and medial antebrachial cutaneous nerve was seen in all the specimens. The posterior interosseous nerve innervation extended beyond the level of the carpometacarpal joints II-V. Conclusions: The modified Sihler's staining technique allows for transparent visibility of the nerves that innervate the dorsal wrist capsule. However, it does not allow as accurate assessment as does histological examination, especially regarding the evaluation of nerve endings. Nevertheless, this method provides a significantly larger area of nerve observation than is provided by histological examination.

Abstract

Background: The aim of this study was to assess the innervation of the dorsal articular capsule of the wrist using modified Sihler’s staining. Materials and methods: Thirty dorsal wrist capsules were collected from 15 donors (both sides) within 12 hours of death. All the capsules were collected in the same manner – using the dorsal incision. The specimens were stained according to the protocol of the modified Sihler’s staining technique. The preserved capsules were analyzed under 8-16× magnification of an optical microscope for the presence of major nerve trunks, their major and minor branches, and nerve connections. Results: The range of innervation visualized was that the posterior interosseous nerve innervated approximately 60% of the central part; the remaining area was innervated by the dorsal sensory branch of the radial nerve and medial antebrachial cutaneous nerve. The constant findings were the branches departing from the ulnar side of the posterior interosseous nerve and from the radial side, with an exception seen in two cases. A communicans branch between the posterior interosseous nerve and medial antebrachial cutaneous nerve was seen in all the specimens. The posterior interosseous nerve innervation extended beyond the level of the carpometacarpal joints II-V. Conclusions: The modified Sihler's staining technique allows for transparent visibility of the nerves that innervate the dorsal wrist capsule. However, it does not allow as accurate assessment as does histological examination, especially regarding the evaluation of nerve endings. Nevertheless, this method provides a significantly larger area of nerve observation than is provided by histological examination.

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Keywords

wrist innervation, Sihler’s staining technique, posterior interosseous nerve, hand surgery, wrist surgery

About this article
Title

Assessing the innervation of the dorsal wrist capsule using modified Sihler’s staining

Journal

Folia Morphologica

Issue

Ahead of Print

Published online

2020-03-03

DOI

10.5603/FM.a2020.0027

Pubmed

32159843

Keywords

wrist innervation
Sihler’s staining technique
posterior interosseous nerve
hand surgery
wrist surgery

Authors

T. Bonczar
J. A. Walocha
M. Bonczar
E. Mizia
J. Filipowska

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