Rubio D A, Pacheco A, Abrilla A
Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
College of Medicine, University of the Philippines Manila, Manila, Philippines.
Malays Orthop J. 2021 Nov;15(3):45-51. doi: 10.5704/MOJ.2111.007.
The radial nerve danger zone (RNDZ) is an important anatomic consideration to anticipate or prevent injury in trauma assessment or surgical fixation. No published estimate currently exists for Filipinos. In this study, we sought to provide a local estimate and explore potential predictors of this anatomic region in Filipino adult cadavers.
Posterior dissection to expose and measure the radial nerve, from the lateral epicondyle to the lateral intermuscular septum, was performed in 60 upper limbs from 30 formalin-preserved cadavers in the laboratory of the Department of Anatomy, College of Medicine, University of the Philippines Manila. Univariate and multivariate linear regression modelling was performed with RNDZ as the dependent variable and age, sex, height and humeral length as potential independent variables individually and in combinations.
The mean radial nerve length from the lateral epicondyle to the lateral intermuscular septum was estimated at 10.6 cm (95% confidence interval: 10.3 cm, 10.9cm). Height and humeral length were statistically significant univariate predictors in female cadavers, while only height was significant in male cadavers. In addition, all multivariate regression models were statistically significant and accounted for more than 57% of the variability in female RNDZ estimates. In comparison, only models that included height and age were statistically significant predictors of RNDZ and accounted for at most 22% of the variability of the estimate in males.
The estimated length of the radial nerve danger zone generated in this study should be strongly considered over other published estimates in surgical fixation procedures performed in adult Filipinos.
桡神经危险区(RNDZ)是创伤评估或手术固定中预测或预防损伤时需要考虑的重要解剖因素。目前尚无针对菲律宾人的公开估计数据。在本研究中,我们试图提供菲律宾成年尸体中该解剖区域的局部估计值,并探索其潜在预测因素。
在菲律宾大学马尼拉医学院解剖学系实验室,对30具福尔马林固定尸体的60条上肢进行后入路解剖,以暴露并测量从外侧髁到外侧肌间隔的桡神经。以RNDZ为因变量,年龄、性别、身高和肱骨长度为潜在自变量,分别及组合进行单变量和多变量线性回归建模。
从外侧髁到外侧肌间隔的桡神经平均长度估计为10.6厘米(95%置信区间:10.3厘米,10.9厘米)。身高和肱骨长度在女性尸体中是具有统计学意义的单变量预测因素,而在男性尸体中只有身高具有统计学意义。此外,所有多变量回归模型均具有统计学意义,且解释了女性RNDZ估计值中超过57%的变异性。相比之下,仅包含身高和年龄的模型是RNDZ具有统计学意义的预测因素,且解释了男性估计值中最多22%的变异性。
在为成年菲律宾人进行的手术固定操作中,本研究得出的桡神经危险区估计长度应比其他已发表的估计值更受重视。