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Title of Journal: Surg Radiol Anat

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Abbravation: Surgical and Radiologic Anatomy

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Springer Paris

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DOI

10.1002/jmr.1065

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1279-8517

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Cadaveric study of anterior and posterior elbow en

Authors: Deepak N Bhatia Bibhas DasGupta Taufiq Panjwani
Publish Date: 2016/02/09
Volume: 38, Issue: 7, Pages: 781-791
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Abstract

The purpose of this study was to describe neurovascular structuresatrisk during establishment of five portals for access to distal biceps tendon DBT in cubital fossa and to establish relative safety of these portal sites for such access We hypothesized that all five portals are safe for endoscopic DBT explorationTen fresh frozen cadaveric elbows were dissected after placement of portals at five potential sites four anterior one posterior Nine neurovascular structures CV cephalic vein LCN lateral cutaneous nerve LV leash of vessels RN radial nerve SRN superficial radial nerve PIN posterior interosseous nerve RA radial artery BA brachial artery MN median nerve were dissected and their distances from portal sites were measured Statistical analysis was performed to determine relative portal safety and risk of injury to neurovascular structures in relation to each portal was analyzedStructures that were significantly “at risk” were RA p = 0006 SRN p = 0002 and PIN p = 0004 RA was significantly “at risk” of injury from portal 4 p = 0009 Similarly SRN was “at risk” from portal 3 p = 0036 and the PIN was “at risk” from portal 2 p = 0003Portal 1 parabiceps portal was safe for all neurovascular structures however portals 2–4 were significantly closer to neurovascular structures RA SRN and PIN were significantly “at risk” as compared to other structures amongst the portals studied Portal 5 was relatively safe for SRN and PINPortals 1 parabiceps portal and 5 distal posterior can be safely placed for endoscopic access to the DBT Portal 4 open distal anterior may be used after careful open dissection and under direct vision Portals 2 and 3 are not recommended for elbow endoscopyThe author certifies that he has no commercial associations eg consultancies stock ownership equity interest patent/licensing arrangements etc that might pose a conflict of interest in connection with the submitted article Institutional review board approval was obtained for this study

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