Intra-individual variations in the bifurcation of the radial nerve and the length of the posterior interosseous nerve
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Date
2011-09-07Author
Benham, Alex
Introwicz, Barbara
Waterfield, Jackie
Sim, Julius
Derricott, Hayley
Mahon, Mike
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Benham, A., Introwicz, B., Waterfield, J., Sim, J., Derricott, H. & Mahon, M. (2012) Intra-individual variations in the bifurcation of the radial nerve and the length of the posterior interosseous nerve. Manual Therapy, 17(1), pp. 22-26.
Abstract
Anatomical literature on the radial nerve predominantly features inter-individual variations, with
comparatively few studies investigating intra-individual variations. The radial nerve has a complex and
variable course, particularly in relation to the location at which the nerve bifurcates to form the
superficial branch of the radial nerve and the posterior interosseous nerve. Variations of the radial nerve
may change the way the nerve and its branches, their blood supply and nerve transmission respond to
forces. This study investigated the presence of intra-individual differences in the bifurcation point of the
radial nerve and the length of the posterior interosseous nerve from the bifurcation to the radial tunnel.
Eighteen embalmed human cadavers were dissected to reveal the radial nerve. Measurements were
taken from the level of the lateral humeral epicondyle to the bifurcation of the radial nerve, and from the
bifurcation to the radial tunnel. All cadavers presented with intra-individual variations between the left
and right limbs. Significant differences were found between the left and right limbs for the measurement
from the lateral humeral epicondyle to the bifurcation (median difference _ 18.0 mm; p _ 0.016) but not
for the measurement from the bifurcation to the radial tunnel (median difference _ 7.0 mm; p _ 0.396).
In conclusion, the location of the radial nerve bifurcation is subject to both intra- and inter-individual
variations. Its specific relationship to the lateral humeral epicondyle also varies, occurring both distal
and proximal to the level of the epicondyle. Clinical implications of these findings warrant further
investigation.