دورية أكاديمية
أعرض في EDS

Optimising safe margins in shoulder surgeries: a cadaveric study on brachial plexus nerves with anthropometric and movement correlation.

التفاصيل البيبلوغرافية
العنوان: Optimising safe margins in shoulder surgeries: a cadaveric study on brachial plexus nerves with anthropometric and movement correlation.
المؤلفون: Kodandapani K; Orthopaedic Dept., Osmania General Hospital, Hyderabad, 500012, India., Sangani K; Orthopaedic Dept., Osmania General Hospital, Hyderabad, 500012, India. mrbonesthehealer@gmail.com., Chakrapani A; Orthopaedic Dept., Osmania General Hospital, Hyderabad, 500012, India., Vedapriya AK; Orthopaedic Dept., Osmania General Hospital, Hyderabad, 500012, India.
المصدر: International orthopaedics [Int Orthop] 2024 Jul; Vol. 48 (7), pp. 1809-1813. Date of Electronic Publication: 2024 Apr 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Verlag Country of Publication: Germany NLM ID: 7705431 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-5195 (Electronic) Linking ISSN: 03412695 NLM ISO Abbreviation: Int Orthop Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Berlin : Springer Verlag
مواضيع طبية MeSH: Cadaver* , Brachial Plexus*/anatomy & histology , Brachial Plexus*/surgery , Humerus*/surgery , Humerus*/innervation, Humans ; Male ; Aged ; Female ; Shoulder/innervation ; Shoulder/surgery ; Acromion/surgery ; Acromion/anatomy & histology ; Middle Aged ; Movement/physiology ; Shoulder Joint/surgery ; Shoulder Joint/innervation ; Shoulder Joint/physiology ; Aged, 80 and over ; Anthropometry/methods
مستخلص: Purpose: Shoulder surgeries, vital for diverse pathologies, pose a risk of iatrogenic nerve damage. Existing literature lacks diverse bone landmark-specific nerve position data. The purpose of this study is to address this gap by investigating such relationships.
Method: This cadaveric study examines axillary, radial and suprascapular nerves' relation with acromion, coracoid and greater tuberosity of the humerus (GT). It also correlates this data with humeral lengths and explores nerve dynamics in relation to arm positions.
Results: The mean distance from the axillary nerve to (i) GT was 4.38 cm (range 3.32-5.44, SD 0.53), (ii) acromion was 6.42 cm (range 5.03-7.8, SD 0.694) and (iii) coracoid process was 4.3 cm (range 2.76-5.84, SD 0.769). Abduction brought the nerve closer by 0.36 cm, 0.35 cm and 0.53 cm, respectively. The mean distance from radial nerve to (i) GT was 5.46 cm (range 3.78-7.14, SD 0.839), (ii) acromion was 7.82 cm (range 5.4-10.24, SD 1.21) and (iii) tip of the coracoid process was 6.09 cm (range 4.07-8.11 cm, SD 1.01). The mean distance from the suprascapular nerve to the acromion was 4.2 cm (range 3.1-5.4, SD 0.575). The mean humeral length was noted to be 27.83 cm (range 25.3-30.7, SD 1.13). There was no significant correlation between these distances and humeral lengths.
Conclusion: It is essential to exercise caution to avoid axillary nerve damage during the abduction manoeuvre, as its distance from the greater tuberosity and tip of the coracoid process has shown a significant reduction. The safe margins, in relation to the length of the humerus and consequently the patient's stature, exhibit no significant variation. In situations where the greater tuberosity (GT) and the border of the acromion are inaccessible due to reasons such as trauma, the tip of the coracoid process can serve as a dependable bone landmark for establishing a secure surgical margin.
(© 2024. The Author(s) under exclusive licence to SICOT aisbl.)
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فهرسة مساهمة: Keywords: Cadaveric study; Iatrogenic nerve injury; Safe margin; Shoulder surgeries
تواريخ الأحداث: Date Created: 20240401 Date Completed: 20240613 Latest Revision: 20240614
رمز التحديث: 20240614
DOI: 10.1007/s00264-024-06163-y
PMID: 38558193
قاعدة البيانات: MEDLINE
الوصف
تدمد:1432-5195
DOI:10.1007/s00264-024-06163-y