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Total Denervation of the Elbow: Cadaveric Feasibility Study
Pierre Laumonerie1, Suzanne Robert2, Meagan E Tibbo3
1Department of Orthopaedic Surgery, Hôpital Pierre-Paul Riquet, Toulouse, France; Anatomy Laboratory, Faculty of Medicine, Toulouse, France.
The Journal of Hand Surgery
|June 2, 2021
Summary
Selective elbow denervation is a feasible surgical option for young patients with severe osteoarthritis, potentially avoiding limitations associated with total elbow arthroplasty. This cadaver study explored two anterior approaches for nerve targeting.
Area of Science:
- Orthopedic Surgery
- Anatomy
- Surgical Innovation
Background:
- Total elbow arthroplasty for severe elbow osteoarthritis presents challenges including postoperative activity limitations and midterm complications.
- Elbow denervation emerges as a potential therapeutic alternative, particularly for younger, active individuals seeking to preserve function.
Purpose of the Study:
- To evaluate the feasibility of performing selective total elbow denervation using two distinct anterior surgical approaches.
Main Methods:
- The study involved 14 cadaver elbows dissected by fellowship-trained elbow surgeons using lateral and medial anterior approaches.
- Key metrics recorded included skin incision lengths, minimum distance between incisions, and identification of articular nerve branches and their proximity to bony landmarks.
Main Results:
- Both anterolateral and anteromedial approaches successfully identified all mixed and sensory nerves in all specimens.
- Specific articular branches identified included those from the musculocutaneous, radial, ulnar, collateral ulnar, posterior cutaneous nerve of the forearm, and medial antebrachial cutaneous nerves.
Conclusions:
- Selective elbow denervation via these two anterior approaches is demonstrated to be feasible in cadavers.
- Targeting articular branches of key nerves is crucial for successful elbow denervation procedures.
