Elsevier

The Journal of Hand Surgery

Volume 25, Issue 5, September 2000, Pages 930-935
The Journal of Hand Surgery

The anatomy of the posterior interosseous nerve as a graft*

https://doi.org/10.1053/jhsu.2000.16359Get rights and content

Thirty upper limbs from skeletally mature embalmed cadavers were studied to determine the anatomic reliability of the posterior interosseous nerve as a donor nerve graft. The posterior interosseous nerve branches 0.43±0.52 cm from the distal edge of the superficial head of the supinator and 8±1.6 cm from the lateral epicondyle form a common leash. There are 6 branches, which are arranged from the ulnar to the radial side at their origin from this leash. The first and second branches supply the extensor digitorum communis, the third branch supplies the extensor carpi ulnaris, the fourth branch supplies the extensor digiti minimi, and the fifth branch arises from the undersurface of the common leash and divides into 2 subbranches (medial and lateral) 10.1±3.2 cm distal to the lateral epicondyle and 12.8±2.2 cm proximal to Lister's tubercle. These 2 subbranches make an inverted V shape around the extensor pollicis longus. The medial branch supplies the extensor pollicis longus and extensor indicis proprius. The lateral branch supplies the extensor pollicis longus and extensor pollicis brevis and ends at the wrist capsule. At a mean distance of 8.1±1.2 cm proximal to Lister's tubercle the lateral subbranch gives off its last muscular branch to the extensor pollicis longus and becomes a pure sensory terminus. As the terminal part of the lateral subbranch approaches the wrist capsule it expands at a mean distance of 1.9±0.5 cm proximal to Lister's tubercle. The sixth branch arises from the radial side of the common leash and divides into 3 subbranches. The first subbranch supplies the abductor pollicis longus and extensor pollicis brevis, the second supplies the abductor pollicis longus, and the third supplies the superficial head of the supinator. This study showed that the mean length obtainable for harvesting the lateral subbranch of the fifth branch of the posterior interosseous nerve is 6.2±0.7 cm, which represents the length of the nerve between the last muscular branch to the extensor pollicis longus to the point at which the nerve expands.

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*

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1

From the Departments of Orthopaedic Surgery and Anatomy, Medical College of Ohio, Toledo, OH.

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