open access

Vol 80, No 1 (2021)
Original article
Submitted: 2020-03-17
Accepted: 2020-04-02
Published online: 2020-04-10
Get Citation

The terminal branch of the posterior interosseous nerve: an anatomic and histologic study

T. Bonczar1, J. A. Walocha1, M. Bonczar2, E. Mizia1, M. Koziej1, P. Piekos1, M. Kujdowicz3
·
Pubmed: 32301104
·
Folia Morphol 2021;80(1):76-80.
Affiliations
  1. Department of Anatomy, Jagiellonian University Medical College, 12th Kopernika Street, 31-034 Cracow, Poland
  2. Intermed Medical Clinic, Zabierzow, Poland
  3. Department of Pathology, Jagiellonian University Medical College, Grzegórzecka 16, 31-531 Kraków

open access

Vol 80, No 1 (2021)
ORIGINAL ARTICLES
Submitted: 2020-03-17
Accepted: 2020-04-02
Published online: 2020-04-10

Abstract

Background: The aim of this study was to evaluate the terminal branch of the posterior interosseous nerve (PIN) by anatomically and histologically assessing the number, dimension, and area of its individual fascicles, by determining the dimension and area of the whole nerve itself, and by calculating the nerve density ratio (ratio of the sum of the areas of individual fascicles to the area of the whole nerve) of the terminal branch of the PIN.

Materials and methods: Twenty-eight terminal branches of the PIN nerve samples were collected from patients undergoing partial denervation of the wrist. The nerve samples were fixed in 10% buffered formalin and stained with haematoxylin and eosin to visualise their nerve bundles. Quantitative analysis of individual fascicles and the whole nerve itself were carried out.

Results: Ten nerve samples (35.7%) had one single fascicle (group 1) while the remaining 18 nerve samples (64.3%) contained 2–9 fascicles (group 2). The difference in the sum of the areas of individual fascicles between the two groups did not constitute a statistical difference. Statistically significant between-group differences (p < 0.05) were seen in the area of whole nerve, the ratio of fascicle area to the nerve cross-sectional area and the cross-section maximum nerve length and width.

Conclusions: The number of nerve fascicles in the terminal branch of the PIN does not affect the overall size of the nerve. The majority of the volume of multi-fascicle nerves, therefore, primarily consists of the internal perineurium. However, due to the low number of nerves, this question cannot be clearly answered. This sets a further direction for further research on a larger group.

Abstract

Background: The aim of this study was to evaluate the terminal branch of the posterior interosseous nerve (PIN) by anatomically and histologically assessing the number, dimension, and area of its individual fascicles, by determining the dimension and area of the whole nerve itself, and by calculating the nerve density ratio (ratio of the sum of the areas of individual fascicles to the area of the whole nerve) of the terminal branch of the PIN.

Materials and methods: Twenty-eight terminal branches of the PIN nerve samples were collected from patients undergoing partial denervation of the wrist. The nerve samples were fixed in 10% buffered formalin and stained with haematoxylin and eosin to visualise their nerve bundles. Quantitative analysis of individual fascicles and the whole nerve itself were carried out.

Results: Ten nerve samples (35.7%) had one single fascicle (group 1) while the remaining 18 nerve samples (64.3%) contained 2–9 fascicles (group 2). The difference in the sum of the areas of individual fascicles between the two groups did not constitute a statistical difference. Statistically significant between-group differences (p < 0.05) were seen in the area of whole nerve, the ratio of fascicle area to the nerve cross-sectional area and the cross-section maximum nerve length and width.

Conclusions: The number of nerve fascicles in the terminal branch of the PIN does not affect the overall size of the nerve. The majority of the volume of multi-fascicle nerves, therefore, primarily consists of the internal perineurium. However, due to the low number of nerves, this question cannot be clearly answered. This sets a further direction for further research on a larger group.

Get Citation

Keywords

terminal branch of the posterior interosseous nerve, wrist denervation, posterior interosseous nerve fascicles, nerve graft

About this article
Title

The terminal branch of the posterior interosseous nerve: an anatomic and histologic study

Journal

Folia Morphologica

Issue

Vol 80, No 1 (2021)

Article type

Original article

Pages

76-80

Published online

2020-04-10

Page views

1156

Article views/downloads

1449

DOI

10.5603/FM.a2020.0041

Pubmed

32301104

Bibliographic record

Folia Morphol 2021;80(1):76-80.

Keywords

terminal branch of the posterior interosseous nerve
wrist denervation
posterior interosseous nerve fascicles
nerve graft

Authors

T. Bonczar
J. A. Walocha
M. Bonczar
E. Mizia
M. Koziej
P. Piekos
M. Kujdowicz

References (22)
  1. Badran H. Digital nerve grafts for insensitive finger tips of thumb and index fingers. Plastic Reconstr Surg. 1997; 99(1): 280.
  2. Bonczar T, Walocha JA, Bonczar M, et al. Assessing the innervation of the dorsal wrist capsule using modified Sihler's staining. Folia Morphol. 2020 [Epub ahead of print].
  3. Chevrollier J, Pedeutour B, Dap F, et al. Evaluation of emergency nerve grafting for proper palmar digital nerve defects: a retrospective single centre study. Orthop Traumatol Surg Res. 2014; 100(6): 605–610.
  4. Chong J. Digital nerve grafts with the lateral antebrachial cutaneous nerve. Plastic Reconstr Surg. 1977; 59(6): 875.
  5. Dellon AL. Partial dorsal wrist denervation: resection of the distal posterior interosseous nerve. J Hand Surg Am. 1985; 10(4): 527–533.
  6. Dellon A, Seif S. Anatomic dissections relating the posterior interosseous nerve to the carpus, and the etiology of dorsal wrist ganglion pain. J Hand Surg. 1978; 3(4): 326–332.
  7. Djurdjevic T, Loizides A, Löscher W, et al. High resolution ultrasound in posterior interosseous nerve syndrome. Muscle Nerve. 2014; 49(1): 35–39.
  8. Elgafy H, Ebraheim NA, Rezcallah AT, et al. Posterior interosseous nerve terminal branches. Clin Orthop Relat Res. 2000(376): 242–251.
  9. Elgafy H, Ebraheim NA, Yeasting RA. The anatomy of the posterior interosseous nerve as a graft. J Hand Surg Am. 2000; 25(5): 930–935.
  10. Ferreres A, Suso S, Ordi J, et al. Wrist denervation. J Hand Surg. 2016; 20(6): 761–768.
  11. Ferreres A, Foucher G, Suso S. Extensive denervation of the wrist. Tech Hand Up Extrem Surg. 2002; 6(1): 36–41.
  12. Foo A, Martin-Playa P, Sebastin Muttath SJ. Arterialized posterior interosseous nerve graft for digital neuroma. Tech Hand Up Extrem Surg. 2019; 23(4): 152–154.
  13. Fukumoto K, Kojima T, Kinoshita Y, et al. An anatomic study of the innervation of the wrist joint and Wilhelm's technique for denervation. J Hand Surg. 1993; 18(3): 484–489.
  14. Gregory T, Goutard M, Gregory J, et al. A Cadaveric Study of the Posterior Interosseous Nerve and Its Branches at the Level of the Distal Radius. J Hand Surg Global Online. 2019; 1(2): 70–73.
  15. Hofmeister EP, Moran SL, Shin AY. Anterior and posterior interosseous neurectomy for the treatment of chronic dynamic instability of the wrist. Hand. 2006; 1(2): 63–70.
  16. Kim Y, Ha DH, Lee SM. Ultrasonographic findings of posterior interosseous nerve syndrome. Ultrasonography. 2017; 36(4): 363–369.
  17. Reissis N, Stirrat A, Manek S, et al. The terminal branch of posterior interosseous nerve: a useful donor for digital nerve grafting. J Hand Surg. 2016; 17(6): 638–640.
  18. Stang F, Stollwerck P, Prommersberger KJ, et al. Posterior interosseus nerve vs. medial cutaneous nerve of the forearm: differences in digital nerve reconstruction. Arch Orthop Trauma Surg. 2013; 133(6): 875–880.
  19. Vanden Berge DJ, Kusnezov NA, Rubin S, et al. Outcomes following isolated posterior interosseous nerve neurectomy: a systematic review. Hand. 2017; 12(6): 535–540.
  20. Waters P, Schwartz JT. Posterior interosseous nerve: An anatomic study of potential nerve grafts. J Hand Surg. 1993; 18(4): 743–745.
  21. Wilgis E, Maxwell G. Distal digital nerve grafts: Clinical and anatomical studies. J Hand Surg. 1979; 4(5): 439–443.
  22. Zwart K, Roeling TAP, van Leeuwen WF, et al. An anatomical study to the branching pattern of the posterior interosseous nerve on the dorsal side of the hand. Clin Anat. 2020; 33(5): 678–682.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.: +48 58 320 94 94, faks: +48 58 320 94 60, e-mail: viamedica@viamedica.pl