Implications of Posterior Interosseus Nerve Distance from the Radial Tuberosity: A Radiologic Study

The posterior interosseus nerve (PIN) courses in close proximity to the bicipital tuberosity and is at potential risk of injury during distal biceps tendon repair using a single-incision technique with bicortical suspensory button, which has recently gained popularity. Axial non-fat suppressed T1-weighted MRI images elbow obtained ten patients, mean age 39 (range 16-70 years), were used measure distance PIN from anatomic insertion, as well line along expected guidewire exit site tuberosity. measurements made 90 degrees pronation, neutral, supination. Mean point was 1.8±1.2mm 5.1±2.9mm 10.3±3.1mm Distance significantly higher supination, compared both pronation (p<0.001) neutral position (p=0.003). footprint 20.3±2.8mm 20.6±2.7mm 19.8±3.0mm not either (p=.343) or (p=0.280). determination reliable consistent prior cadaveric study. Supination increased distance, suggesting that less likely injure this repair. Maximal forearm supination therefore recommended when performing ensure maximal radial We postulate injuries occurring are result aberrant retractor placement. recommend against use retractors deep neck. Guidewire placement safe.