According to the authors of a study from Sacramento, California, 'The aim of this study was to evaluate the effect that different drill trajectories across the radius have on the proximity of the drill tip to the posterior interosseous nerve (PIN). In 10 cadaveric specimens, we drilled from the bicipital tuberosity across the radius using 4 different trajectories: (1) aiming across the radius at 90 degrees to the longitudinal axis of the radius, (2) distally at 45 degrees, (3) ulnarly, and (4) radially.'
'We measured the distance between the tip of the drill as it exited the dorsal cortex of the radius and the PIN. Aiming 90 degrees across the radius and aiming ulnarly across the radius resulted in a distance of 11.2 +/- 3.2 mm (95% confidence interval [CI], 8.9 to 13.5 mm) and 16.0 +/- 3.8 mm (95% CI, 13.3 to 18.7 mm), respectively, between the drill tip and the PIN. Aiming the drill 45 degrees distally and aiming radially resulted in a distance of only 2.0 +/- 2.2 mm (95% CI, 0.5 to 3.6 mm) and 4.2 +/- 2.2 mm (95% CI, 2.6 to 5.8 mm), respectively. The differences were found to be statistically significant. On the basis of the results of this anatomic study, when using the cortical button distal biceps repair technique, we recommend drilling across the radius at 90 degrees to its longitudinal axis and aiming from 0 degrees to 30 degrees ulnarly, with the patient's forearm in full supination. This provides an increased margin of safety to prevent injury to the PIN compared with drilling radially or distally,' wrote E.Y. Lo and colleagues, University of California (see also Arthroscopy).
The researchers concluded: 'By avoiding distal and radial drilling, the risks of PIN injury should be minimized during distal biceps tendon repair.'
Lo and colleagues published the results of their research in Arthroscopy-Journal of Arthroscopic and Related Surgery (The Effect of Drill Trajectory on Proximity to the Posterior Interosseous Nerve During Cortical Button Distal Biceps Repair. Arthroscopy-Journal of Arthroscopic and Related Surgery, 2011;27(8):1048-1054).
For additional information, contact E.Y. Lo, University of California, Dept. of Public Health Science, Division Biostatistics, Sacramento, CA 95817, United States.
The publisher of the Arthroscopy-Journal of Arthroscopic and Related Surgery can be contacted at: W B Saunders Co-Elsevier Inc., 1600 John F Kennedy Boulevard, Ste. 1800, Philadelphia, PA 19103-2899, USA.
Keywords: City:Sacramento, State:California, Country:United States, Region:North and Central America
This article was prepared by Medical Devices & Surgical Technology Week editors from staff and other reports. Copyright 2011, Medical Devices & Surgical Technology Week via NewsRx.com.
