Anatomical relations of the superficial sensory branches of the radial nerve: a cadaveric study with clinical implications

The study was a descriptive anatomical study. Twenty-five forearms were dissected. Measurements were made from predefined fixed reference points.The mean distance to the point of emergence of the nerve from the radial styloid was 8.54 cm (SD = 1.32). The nerve branched at a mean distance of 5.57 cm (SD = 1.43) from the radial styloid. The mean distance to the point where the most medial and most lateral branches of the nerve crossing the wrist joint, measured from the Lister's tubercle were 2.51 cm (SD = 0.53) and 3.90 cm (SD = 0.64). In 17 specimens(68%) cephalic vein crossed the SBRN superficially once. Mean distance from the radial styloid to the most distal point where the vein crossed the nerve was 5.10 cm. Diffefrence between mean distance to the point of emergence and branching point, when compared with other international studies were not statistically significant. (P value > 0.05)We recommend avoiding transverse incisions in the snuffbox region between 2.51 cm and 3.90 cm from the Listers tubercle. We also recommend avoiding cannulation of the cephalic vein in the distal forearm.The superficial position of the sensory branch of the radial nerve (SBRN) is vulnerable to injury during a variety of surgical procedures including orthopedic percutaneous wire fixation, cephalic vein cannulation and arthroscopic surgery of the wrist joint.In a study conducted by Glanvill, R. et al [1] the incidence of superficial radial nerve injury after Kirchner wire insertion by an experienced orthopedic surgeon was assessed. K-wires were inserted into the radii of 92 adult cadavers. Subsequent dissection of the area exposed the superficial radial nerve and any observed nerve injury was documented. It was concluded that nerve injury may still occur as a result of K-wire insertion.In a similar cadaveric study conducted by Vandersluis, R. et al [2], risk of soft-tissue injury during percutaneous placement of external fixation pins in the proximal radius was assessed. It was noted