Bone and Nerve Response to Sciatic Compression Neuropathy in a Rabbit Model.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 13. Muscle Nerve. 2021 Dec;64(6):749-754. doi: 10.1002/mus.27408. Epub 2021 Sep 10. Cubital tunnel perfusion in different postures-An anatomical investigation. Rossmann T(1)(2), Heber UM(1), Heber S(3), Reissig LF(1), Grisold W(4), Weninger WJ(1), Meng S(1)(5). Author information: (1)Division of Anatomy, Medical University of Vienna, Vienna, Austria. (2)Department of Neurosurgery, Neuromed Campus, Kepler University Hospital, Linz, Austria. (3)Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria. (4)Neurology Consultancy Unit, Division of Anatomy, Medical University of Vienna, Vienna, Austria. (5)Department of Radiology, Hanusch Hospital, Vienna, Austria. INTRODUCTION/AIMS: For cubital tunnel syndrome, the avoidance of predisposing arm positions and the use of elbow splints are common conservative treatment options. The rationale is to prevent excessive stretching and compression of the nerve in the cubital tunnel, as this mechanical stress impedes intraneural perfusion. Data regarding those upper extremity postures to avoid, or whether elbow flexion alone is detrimental, are inconsistent. This study aimed to assess perfusion and size changes of the cubital tunnel during different postures in an experimental cadaver setup. METHODS: Axillary arteries in 30 upper extremities of fresh cadavers were injected with ultrasound contrast agent. High-resolution ultrasound of the cubital tunnel was performed during five different arm postures that gradually increased tension on the ulnar nerve and caused cubital tunnel narrowing. Contrast enhancement within the tunnel was measured to quantify perfusion. Cubital tunnel cross-sectional area was measured to detect compression. RESULTS: Increasing tension significantly reduced perfusion. When isolated, neither shoulder elevation, elbow flexion, pronation, nor extension of wrist and fingers impaired perfusion. However, combining two or more of these postures led to significant decreases. Significant narrowing of the cubital tunnel was seen in full elbow flexion and shoulder elevation. DISCUSSION: Combinations of some upper extremity joint positions reduce nerve perfusion, but isolated elbow flexion does not have a significant impact. We hypothesize that elbow splints alone may not influence cubital tunnel perfusion but may only prevent direct compression of the ulnar nerve. Advising patients about upper extremity postures that should be avoided may be more effective. © 2021 The Authors. Muscle & Nerve published by Wiley Periodicals LLC. DOI: 10.1002/mus.27408 PMCID: PMC9292220