Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY, USA.
School of Medicine, University of Louisville, Louisville, KY, USA.
J Plast Surg Hand Surg. 2021 Feb;55(1):17-20. doi: 10.1080/2000656X.2020.1828895. Epub 2020 Oct 10.
Proper injection of the posterior interosseous nerve (PIN) is important for both the therapeutic and diagnostic management of wrist pain. However, no anatomical study exists describing the site of injection based on individual wrist width. We sought to develop a reproducible anthropometric ratio utilizing external wrist surface anatomy to predict a safe and accurate injection site for the PIN. Fresh frozen cadaver forearms were dissected at the University of Louisville tissue lab. Several anthropometric measurements were obtained in order to develop a reproducible ratio to calculate location of injection. A total of 16 cadaver forearms of equal male to female ratio were obtained. On average, the male forearm had a greater mean wrist circumference obtained at the level of Lister's tubercle compared to female forearms, 17.1 cm vs. 13.5 cm. An injection given ulnar to proximal edge of Lister's tubercle at a length of one-fourth the distance between Lister's tubercle and radial aspect of ulnar styloid resulted in 100% accurate perineural injection without intraneural injection. An anthropometric ratio of one-fourth the distance from Lister's tubercle to the ulnar styloid was able to predict accurate injection sites for the distal PIN in cadaveric specimens of varying anatomical proportions.
正确注射骨间后神经（PIN）对于腕痛的治疗和诊断管理都很重要。然而，目前尚无基于个体腕宽描述注射部位的解剖学研究。我们试图利用腕部外表面解剖学开发一种可重复的人体测量比值，以预测 PIN 的安全准确注射部位。在路易斯维尔大学组织实验室对新鲜冷冻的尸体前臂进行了解剖。为了开发一种可重复的比值来计算注射部位，我们获得了几个人体测量学测量值。总共获得了 16 个男女比例相等的尸体前臂。平均而言，男性前臂在 Lister 结节水平的腕周径大于女性前臂，分别为 17.1cm 和 13.5cm。在 Lister 结节和尺骨茎突桡侧之间距离的四分之一处，从尺侧近端边缘到 Lister 结节的注射，结果为 100%的皮神经内注射，没有神经内注射。Lister 结节到尺骨茎突的距离的四分之一的人体测量比值能够预测在具有不同解剖比例的尸体标本中，PIN 远端的准确注射部位。
