Search

The supracondylar process is a nonpathological projection from the distal humerus that in some patients, can result in compression of regional neurovascular structures, for example, median nerve. Since the first description of the supracondylar process in 1818, it has also been a focus of anthropological study because of its possible relevance to human origins and relationships to other species. Although its overall incidence is low, it is more common in races of European descent. It is particularly interesting for anatomists and anthropologists, but knowledge of its anatomical relationships and effect on pathological processes helps in the diagnosis and treatment of supracondylar process syndrome. One of the most detailed descriptions of this variant process stems from the work of Buntaro Adachi. Herein, a translation of his findings is provided and a review of the supracondylar process and its potential pathological presentations presented., (© 2021 American Association of Clinical Anatomists.)

External fixation is a common, efficient technique used for humeral shaft stabilization and elbow fractures. There are reports of radial nerve injuries associated with this procedure. In this study, we investigated the course and variability of the radial nerve along the lateral humerus in relation to the elbow joint to determine a relatively safe zone for lateral pin placement in external fixation. Twenty upper extremities from 10 cadavers were studied. The nerve branches and course of the radial nerve along the lateral humerus were carefully dissected. Straight lines (a, b, and c) were made connecting three landmarks (the acromion, coracoid process, and anterior wall of the axilla) in the proximal upper extremity to the lateral condyle (LC) of the humerus; their intersections with the radial nerve (A, B, and C) were marked. We analyzed whether the intersection positions were correlated with the connecting line lengths. The mean lengths of the connecting lines were (a) 27.24 ± 2.57, (b) 26.18 ± 2.79, and (c) 20.95 ± 1.44 cm; the distance between the intersection points and the LC of the humerus were (Aa) 7.56 ± 1.31, (Bb) 6.90 ± 2.27, and (Cc) 5.01 ± 0.83 cm; and the measured intersection points of the radial nerve in the lateral aspect of the humerus were (A) 18.48%-34.82%, (B) 13.48%-40.00%, and (C) 19.27%-28.05% of the lengths of lines a, b, and c, respectively. Our data provide a more reliable reference to predict the course of the radial nerve on the lateral humerus and define a safe zone for pin placement. Clin. Anat., 33:637-642, 2020. © 2019 Wiley Periodicals, Inc., (© 2019 Wiley Periodicals, Inc.)

The aim of this study was to determine the feasibility of applying MIPO of the humerus via the posterior approach and to observe the tension of the radial nerve in different elbow positions. Two separate incisions were made on the posterior aspect of the humerus in ten fresh cadavers (20 humeri). The radial nerve was identified at the proximal incision and the distances through which the nerve could be elevated from the bone with the elbow in flexion and extension were measured. A 10-hole extra-articular distal humeral locking compression plate was inserted and fixed through the submuscular tunnel. The tunnel was then explored to identify any entrapment of the radial nerve and to observe the anatomical relationship of the radial nerve to the plate and bone. There was no entrapment of the radial nerve or its branches. The distances through which the radial nerve could be elevated were greater with the elbow in extension than in flexion (P < 0.01). The radial nerve crossed the medial and lateral borders of the posterior surface of the humerus at 80.1-132 mm (average 104.7 mm) and 116.6-175.5 mm (average 142.7 mm) of its total length, respectively. The axillary nerve was located at 38.7-61.7 mm (average 47.9 mm) of total humeral length. MIPO of the humerus using the posterior approach is an alternative option for treating distal humeral shaft fracture. The risk of radial nerve injury can be minimized by careful dissection in the proximal incision. Clin. Anat. 32:176-182, 2019. © 2018 Wiley Periodicals, Inc., (© 2018 Wiley Periodicals, Inc.)