We conducted an anatomical study to determine
the best technique for transfer of the anterior interosseous nerve (AIN)
for the treatment of proximal ulnar nerve injuries. The AIN, ulnar
nerve, and associated branches were dissected in 24 cadaver arms.
The number of branches of the AIN and length available for transfer
were measured. The nerve was divided just proximal to its termination
in pronator quadratus and transferred to the ulnar nerve through
the shortest available route. Separation of the deep and superficial
branches of the ulnar nerve by blunt dissection alone, was also
assessed. The mean number of AIN branches was 4.8 (3 to 8) and the
mean length of the nerve available for transfer was 72 mm (41 to
106). The transferred nerve reached the ulnar nerve most distally
when placed dorsal to flexor digitorum profundus (FDP). We therefore
conclude that the AIN should be passed dorsal to FDP, and that the
deep and superficial branches of the ulnar nerve require approximately
30 mm of blunt dissection and 20 mm of sharp dissection from the
point of bifurcation to the site of the anastomosis. The use of this technique for transfer of the AIN should improve
the outcome for patients with proximal ulnar nerve injuries. Cite this article:
The purpose of this study was to determine whether
it would be feasible to use oblique lumbar interbody fixation for
patients with degenerative lumbar disease who required a fusion
but did not have a spondylolisthesis. A series of CT digital images from 60 patients with abdominal
disease were reconstructed in three dimensions (3D) using Mimics
v10.01: a digital cylinder was superimposed on the reconstructed
image to simulate the position of an interbody screw. The optimal
entry point of the screw and measurements of its trajectory were
recorded. Next, 26 cadaveric specimens were subjected to oblique
lumbar interbody fixation on the basis of the measurements derived
from the imaging studies. These were then compared with measurements
derived directly from the cadaveric vertebrae. Our study suggested that it is easy to insert the screws for
L1/2, L2/3 and L3/4 fixation: there was no significant difference
in measurements between those of the 3-D digital images and the
cadaveric specimens. For L4/5 fixation, part of L5 inferior articular
process had to be removed to achieve the optimal trajectory of the
screw. For L5/S1 fixation, the screw heads were blocked by iliac
bone: consequently, the interior oblique angle of the cadaveric specimens
was less than that seen in the 3D digital images. We suggest that CT scans should be carried out pre-operatively
if this procedure is to be adopted in clinical practice. This will
assist in determining the feasibility of the procedure and will
provide accurate information to assist introduction of the screws. Cite this article:
