SavedAdd your journal

Journals / Acta Orthopaedica et Traumatologica Turcica / 2014 / Cilt: 48 - Sayı: 5

Relationship between axillary nerve and percutaneously inserted proximal humeral locking plate: a cadaver study

CEM ZEKİ ESENYEL
Semih DEDEOĞLU
Yunus İMREN
SİNAN KAHRAMAN
Murat ÇAKAR
KAHRAMAN ÖZTÜRK
Pages
553–557
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The axillary nerve must be visible during application of the screws due to the impossibility of knowing which holes cross the axillary nerve.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: The aim of this study was to investigate the relationship between the axillary nerve and the percutaneously inserted proximal humeral locking plate and to evaluate the risk of axillary nerve injury during percutaneous plate insertion.Methods: The study included 50 shoulders of 25 fresh frozen cadavers.
📊
Key Findings & Data:A 5 cm incision was made from the anterolateral border of the acromion to the arm and a 5-hole 3.5-mm proximal humeral plate was inserted.
💡
Conclusion & Impact:The axillary nerve must be visible during application of the screws due to the impossibility of knowing which holes cross the axillary nerve.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: The aim of this study was to investigate the relationship between the axillary nerve and the percutaneously inserted proximal humeral locking plate and to evaluate the risk of axillary nerve injury during percutaneous plate insertion.Methods: The study included 50 shoulders of 25 fresh frozen cadavers. A 5 cm incision was made from the anterolateral border of the acromion to the arm and a 5-hole 3.5-mm proximal humeral plate was inserted. The axillary nerve was then dissected. Plate holes which crossed the axillary nerve were noted. The distance between the axillary nerve and the lateral edge of the acromion and the length of the arm were measured and their relations evaluated with a correlation test.Results: The average arm length was 319 mm. The average distance between the axillary nerve and the lateral edge of the acromion was 60 mm. There was a significant correlation between the arm length and acromion-axillary nerve distance (p<0.05). The plate was inserted under the deltoid fascia in all shoulders except one. There were no axillary nerve lesions. In 1 case, the distal end of the plate was inserted in the deltoid muscle. No constant relationship between the plate holes and the axillary nerve was detected.Conclusion: There is a risk of axillary nerve injury during percutaneous plate insertion. It must be ensured that the plate is inserted under the deltoid fascia during the surgery. The axillary nerve must be visible during application of the screws due to the impossibility of knowing which holes cross the axillary nerve.

🔖

Cite This Article

ESENYEL, C. Z., DEDEOĞLU, S., İMREN, Y., KAHRAMAN, S., ÇAKAR, M., ÖZTÜRK, K. (2014). Relationship between axillary nerve and percutaneously inserted proximal humeral locking plate: a cadaver study. Acta Orthopaedica et Traumatologica Turcica, Cilt: 48 - Sayı: 5, 553–557. https://ajindex.com/articles/354594

References (14)

  1. Court-Brown CM, Garg A, McQueen MM. The epidemiology of proximal humeral fractures. Acta Orthop Scand 2001;72:365-71
  2. Nho SJ, Brophy RH, Barker JU, Cornell CN, MacGillivray JD. Management of proximal humeral fractures based on current literature. J Bone Joint Surg Am 2007;89 Suppl 3:44-58
  3. Helmy N, Hintermann B. New trends in the treatment of proximal humerus fractures. Clin Orthop Relat Res 2006;442:100-8
  4. Resch H, Beck E, Bayley I. Reconstruction of the valgusimpacted humeral head fracture. J Shoulder Elbow Surg 1995;4:73-80
  5. Szyszkowitz R, Seggl W, Schleifer P, Cundy PJ. Proximal humeral fractures. Management techniques and expected results. Clin Orthop Relat Res 1993;(292):13-25
  6. Cuomo F, Flatow EL, Maday MG, Miller SR, McIlveen SJ, Bigliani LU. Open reduction and internal fixation of two- and three-part displaced surgical neck fractures of the proximal humerus. J Shoulder Elbow Surg 1992;1:287- 95
  7. Goldman RT, Koval KJ, Cuomo F, Gallagher MA, Zuckerman JD. Functional outcome after humeral head replacement for acute three- and four-part proximal humeral fractures. J Shoulder Elbow Surg 1995;4(2):81-6
  8. Moeckel BH, Dines DM, Warren RF, Altchek DW. Modular hemiarthroplasty for fractures of the proximal part of the humerus. J Bone Joint Surg Am 1992;74:884-9
  9. Laflamme GY, Rouleau DM, Berry GK, Beaumont PH, Reindl R, Harvey EJ. Percutaneous humeral plating of fractures of the proximal humerus: results of a prospective multicenter clinical trial. J Orthop Trauma 2008;22(3):153-8
  10. Naidu SH, Bixler B, Capo JT, Moulton MJ, Radin A. Percutaneous pinning of proximal humerus fractures: a biomechanical study. Orthopedics 1997;20:1073-6
  11. Gardner MJ, Griffith MH, Dines JS, Briggs SM, Weiland AJ, Lorich DG. The extended anterolateral acromial approach allows minimally invasive access to the proximal humerus. Clin Orthop Relat Res 2005;434:123-9
  12. Smith J, Berry G, Laflamme Y, Blain-Pare E, Reindl R, Harvey E. Percutaneous insertion of a proximal humeral locking plate: an anatomic study. Injury 2007;38:206-11
  13. Lau TW, Leung F, Chan CF, Chow SP. Minimally invasive plate osteosynthesis in the treatment of proximal humeral fracture. Int Orthop 2007;31:657-64. Minimally invasive reduction and osteosynthesis of articular fractures of the humeral head. Injury 2001;32 Suppl 1:SA25-32
  14. Resch H, Povacz P, Fröhlich R, Wambacher M. Percutaneous fixation of three- and four-part fractures of the proximal humerus. J Bone Joint Surg Br 19