title: A Cadaver Study of Median-to-Radial Nerve Transfer for Radial Nerve Injuries.
abstract: OBJECTIVE
  To assess the anatomic feasibility of a median-to-radial nerve transfer in cadaver limbs and to quantify the number of axons present in the cut ends of the involved donor and recipient nerves.
  
  
  METHODS
  Ten fresh frozen cadaveric upper limbs were dissected. We investigated whether the flexor carpi radialis (FCR) branch/flexor digitorum superficialis (FDS) branch (donor nerve) reached the posterior interosseous nerve (PIN)/extensor carpi radialis brevis (ECRB) branch (recipient nerve) without tension. We also investigated the length of the transected supinator fascia for FCR-posterior interosseous nerve transfer and the FDS-ECRB positional relationship using the epicondyle line and the midline of the forearm as axes. The findings were used for these 2 types of nerve transfer with evaluation closer to the target muscles. The distance between the point at which the FDS and ECRB branches met and the point at which the ECRB branch entered the muscle was measured. After nerve coaptation, the axon number was determined by histological evaluation.
  
  
  RESULTS
  In all limbs, the FCR and FDS branches reached the PIN and the ECRB branch without tension. The transected supinator fascia was 17 (3-25) mm long. The point at which the FDS branch reached the ECRB branch [corrected] was 48 (23-65) mm distal to the epicondyle line and approximately 23 (18-27) mm radial to the midline of the forearm. The distance between the point at which the FDS and ECRB branches met and the point at which the ECRB branch entered the muscle was 27 (17-40) mm. The mean axon numbers were FCR, 1501 (932-3022); PIN, 5162 (4325-7732); FDS, 885 (558-962); and ECRB, 548 (433-723).
  
  
  CONCLUSIONS
  The FCR branch could be transferred to the PIN [corrected] and the FDS to the ECRB branch in all limbs without tension.
  
  
  CONCLUSIONS
  We provide anatomical and histological information for median-to-radial nerve transfer.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan. Electronic address: helpandriver502@gmail.com.
authors.forename: Koji
authors.initials: K
authors.lastname: Sukegawa
authors.affiliation: Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
authors.forename: Takane
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsuura
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kuniyoshi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001369:Axons / Q000473:pathology; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000033:anatomy & histology / Q000601:surgery*; D018482:Muscle, Skeletal / Q000294:innervation / Q000601:surgery; D016067:Nerve Transfer / Q000379:methods*; D011826:Radial Nerve / Q000033:anatomy & histology / Q000293:injuries* / Q000601:surgery*
keywords: Anatomical study; median nerve; nerve transfer; radial nerve; radial nerve injuries