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Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
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Anatomical Study of the Innervation of Triangular Fibrocartilage Complex and Distal Radioulnar and Radiocarpal
John Tran1, Loretta Ho2, Herbert P von Schroeder3
1Division of Anatomy, Department of Surgery, University of Toronto, Toronto, Canada.
The Journal of Hand Surgery
|July 23, 2022
Summary
This study mapped nerves supplying the triangular fibrocartilage complex (TFCC), distal radioulnar joint (DRUJ), and radiocarpal joint (RCJ). Understanding these nerve pathways and anatomical landmarks helps guide targeted wrist denervation for pain relief.
Area of Science:
- Anatomy
- Surgical Procedures
- Pain Management
Background:
- Open and percutaneous denervation are emerging techniques for managing joint pain.
- Accurate anatomical knowledge is crucial for effective denervation procedures.
Purpose of the Study:
- To investigate the course and distribution of articular nerve branches supplying the TFCC, DRUJ, and RCJ.
- To identify bony and soft tissue landmarks for guiding wrist denervation.
Main Methods:
- Serial dissection of 14 formalin-embalmed specimens.
- Documentation of nerve origins, courses, and distributions.
- 3D reconstruction of distal forearm and hand bones with landmark visualization.
Main Results:
- Multiple nerves innervate the TFCC, DRUJ, and RCJ.
- Detailed innervation patterns were identified for each joint.
- Specific anatomical landmarks were correlated with articular nerve branches.
Conclusions:
- The identified anatomical landmarks can inform selective denervation procedures.
- Understanding nerve supply aids in determining the structural origin of wrist pain.
- This research provides a basis for optimizing and developing new denervation protocols for chronic wrist pain.
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