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Spinal Nerves: Plexus I01:22

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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
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Bones of the Upper Limb: Radius01:09

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The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
The radius has a nail-shaped head, and a...
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Bones of the Upper Limb: Ulna01:15

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The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...
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Assessment of Radial Pulse
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The muscles of the forearm that move the wrist, hand, and digits are numerous and diverse. They can be classified into two groups based on their location and function — the anterior and posterior compartment muscles.
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The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...
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Author Spotlight: Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome
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Lateral External-fixation Adjacent to Radial Nerve.

Benjamin F Plucknette1, David J Tennent1, Joseph R Hsu2

  • 1Orthopaedic Surgery, San Antonio Military Medical Center, San Antonio, USA.

Cureus
|May 1, 2020
PubMed
Summary
This summary is machine-generated.

Humeral external fixation in active-duty service members often violates radial nerve safe zones, leading to a 40% incidence of nerve injury. This treatment for combat injuries may result in long-term deficits and medical retirement.

Keywords:
combat traumaexternal fixationradial nerveupper extremity external fixation

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Neurotrauma

Background:

  • External fixation is used for severe upper extremity injuries in combat.
  • The radial nerve is at risk during humeral external fixation.
  • Defining safe zones for pin placement is crucial for preventing nerve injury.

Purpose of the Study:

  • To describe injury patterns and outcomes in active-duty service members treated with humeral external fixation.
  • To determine if violating radial nerve safe zones correlates with radial nerve injury.

Main Methods:

  • Retrospective review of US service members treated with humeral external fixation (June 2005-June 2015).
  • Analysis of injury mechanism, fracture pattern, pin placement relative to radial nerve safe zones, and pre/postoperative radial nerve function.
  • Defined proximal and distal radial nerve safe zones.

Main Results:

  • 16 active-duty subjects were included; 94% had external fixator pins placed outside defined radial nerve safe zones.
  • 40% of subjects with known preoperative nerve function developed postoperative deficits.
  • Approximately 50% of all subjects required medical retirement.

Conclusions:

  • External fixation for combat-related upper extremity injuries is infrequently indicated.
  • Pin placement outside radial nerve safe zones is common and associated with a high incidence of radial nerve injury.
  • Humeral external fixation in this population is linked to significant nerve injury and long-term disability.