title: Cadaveric investigation on radial nerve strain using different posterior surgical exposures for extraarticular distal humeral ORIF: merits of nerve decompression through a lateral paratricipital exposure.
abstract: OBJECTIVE
  To determine whether the type of posterior surgical approach for distal humeral fracture open reduction and internal fixation influenced radial nerve strain during simulated operative retraction in a cadaveric model.
  
  
  METHODS
  Three different posterior surgical exposures: triceps splitting, lateral paratricipital, and paratricipital with release of the lateral intermuscular septum were used. Radial nerve strain was measured using a microDVRT, while traction was applied with a digital force gauge at forces 0.1-0.3 kg.
  
  
  RESULTS
  The lateral paratricipital with nerve decompression was superior to both the triceps splitting approach (P < 0.048) and paratricipital method without decompression (P < 0.036). There was no significant difference between the triceps splitting method and paratricipital exposure without intermuscular septum release.
  
  
  CONCLUSIONS
  Radial nerve decompression through release of the lateral intermuscular septum through a lateral paratricipital exposure ideally decreases nerve strain during humeral open reduction and internal fixation in our cadaveric model.
authors: Department of Orthopaedic Surgery, Division of Orthopaedie Traumatology, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Clifford
authors: C
authors: Voigt
authors: Emmanuel
authors: E
authors: Illical
authors: Kanu S
authors: KS
authors: Goyal
authors: Dana J
authors: DJ
authors: Farrell
authors: Carola F
authors: CF
authors: Van Eck
authors: Ivan S
authors: IS
authors: Tarkin
mesh_terms: D000368:Aged; D019299:Decompression, Surgical; D004551:Elbow Joint / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D059348:Peripheral Nerve Injuries / Q000209:etiology / Q000517:prevention & control*; D011826:Radial Nerve / Q000293:injuries* / Q000601:surgery*