title: A cadaveric assessment of the risk of nerve injury during open subpectoral biceps tenodesis using a bicortical guidewire.
abstract: OBJECTIVE
  To evaluate the risk of neurological injury from the placement of a bicortical guidewire during subpectoral biceps tenodesis.
  
  
  METHODS
  Ten forequarter cadaver specimens were evaluated. A bicortical guidewire was placed, and measurements to important local neurological structures were made with digital calipers at open dissection.
  
  
  RESULTS
  The mean (range, SD) distances from the guidewire to the respective nerves was as follows: axillary nerve posteriorly, 15.7 mm (10-22 mm, 3.4); axillary nerve laterally, 18.7 mm (12-27 mm, 4.3); radial nerve posteriorly, 26.2 mm (16-35 mm, 7.0); radial nerve medially, 25 mm (16-33 mm, 4.4); and musculocutaneous nerve, 20.1 mm (12-26 mm, 5.2).
  
  
  CONCLUSIONS
  There has been some disagreement in the literature regarding the proximity of a bicortical guidewire to the axillary nerve posteriorly. The results of this study concur with reports from several other authors and demonstrate that this nerve is at risk of iatrogenic injury when using this technique. The clinical relevance of this work is to allow surgeons to better understand the proximity of the nerve to a bicortical guidewire and to highlight that this risk is avoided with a unicortical technique.
authors.affiliation: Pan Am Clinic, 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada. adnan.saithna@nhs.net.|Department of Orthopaedic Surgery, Southport and Ormskirk Hospitals NHS Trust, Town Lane, Southport, PR8 6PN, UK. adnan.saithna@nhs.net.
authors.forename: Adnan
authors.initials: A
authors.lastname: Saithna
authors.affiliation: Pan Am Clinic, 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada.|Department of Human Anatomy and Cell Science, College of Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: Alison
authors.initials: A
authors.lastname: Longo
authors.affiliation: Department of Orthopaedic Surgery, Southport and Ormskirk Hospitals NHS Trust, Town Lane, Southport, PR8 6PN, UK.
authors.forename: R W
authors.initials: RW
authors.lastname: Jordan
authors.affiliation: Pan Am Clinic, 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada.|Section of Orthopaedic Surgery, College of Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: Jeff
authors.initials: J
authors.lastname: Leiter
authors.affiliation: Pan Am Clinic, 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada.|Section of Orthopaedic Surgery, College of Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: MacDonald
authors.affiliation: Pan Am Clinic, 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada.|Section of Orthopaedic Surgery, College of Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Old
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000601:surgery*; D002102:Cadaver; D004210:Dissection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D019635:Neurosurgical Procedures; D011826:Radial Nerve / Q000293:injuries*; D019651:Plastic Surgery Procedures; D018570:Risk Assessment; D053656:Tenodesis / Q000009:adverse effects* / Q000379:methods
keywords: Biceps tenodesis; Bicortical guidewire; Nerve injury; Subpectoral