The accuracy of distal posterior interosseous and anterior interosseous nerve injection.
OBJECTIVE
To standardize a technique of delivering a local anesthetic to the posterior interosseous nerve (PIN) and anterior interosseous nerve (AIN) by using the anatomic landmarks of the wrist and to evaluate the accuracy of the technique in a cadaver model.


METHODS
Techniques for PIN and AIN injection and for PIN injection alone are described. Techniques were tested in a fresh frozen cadaver model by using methylene blue injections. Stained nerves were dissected under loupe magnification. Digital photographic images were taken of each nerve. Staining was quantified by calculating the mean density and area stained.


RESULTS
For both techniques methylene blue was delivered accurately to the PIN in 100% of the samples. Methylene blue was delivered accurately to the AIN in 100% of samples in which it was injected.


CONCLUSIONS
These techniques saturated successfully the PIN and AIN and may be useful as diagnostic and therapeutic tools for chronic wrist pain and in evaluating presurgically the effectiveness of partial wrist denervation.
Department of Orthopaedic Surgery, Wayne State University, Detroit, MI 48201, USA.
Paul W
PW
Grutter
Gregory L
GL
Desilva
Robert E
RE
Meehan
Stephen P
SP
Desilva
D000779:Anesthetics, Local / Q000008:administration & dosage; D002102:Cadaver; D004396:Coloring Agents; D006801:Humans; D015552:Injections, Intralesional; D008475:Median Nerve; D008751:Methylene Blue; D009407:Nerve Block / Q000379:methods*; D010146:Pain / Q000188:drug therapy; D011826:Radial Nerve; D015203:Reproducibility of Results; D014953:Wrist / Q000294:innervation* / Q000473:pathology
D000779:Anesthetics, Local; D004396:Coloring Agents; D008751:Methylene Blue