JOURNAL ARTICLE
Add like
Add dislike
Add to saved papers

The effect of drilling angle on posterior interosseous nerve safety during open and endoscopic anterior single-incision repair of the distal biceps tendon.

Arthroscopy 2008 March
PURPOSE: The purpose of this study was to define a safe trajectory with regard to iatrogenic posterior interosseous nerve (PIN) injury when drilling the bicipital tuberosity for EndoButton repair (Smith & Nephew Endoscopy, Andover, MA) of distal biceps tendon ruptures.

METHODS: Ten cadaveric forearms were dissected. The bicipital tuberosity was exposed and the biceps tendon detached. The supinator and PIN were exposed dorsally. A K-wire was drilled perpendicular to the surface of the tuberosity. By use of digital calipers, the distance from the exit point of this wire to the PIN was measured. The length of the bone tunnel was also measured. This wire was removed, and a second was drilled from the same starting point but directed 30 degrees ulnarly. Measurements were repeated. A Wilcoxon signed rank test was used to compare the distances of the K-wire to the PIN and the tunnel lengths for both trajectories.

RESULTS: With the perpendicular wire, the mean distance to the PIN was 11.1 mm. When directed 30 degrees ulnarly, the mean distance was 16.4 mm. The difference was significant (P < .001). The mean bone tunnel lengths for the 2 trajectories were 17.8 mm and 18.1 mm; this was not found to be significant (P = .508).

CONCLUSIONS: When drilling the bicipital tuberosity, we advocate starting at a center-center position on the face of the tuberosity, holding the forearm in maximum supination, and aiming 30 degrees ulnarly to decrease the risk to the PIN. This trajectory does not decrease the bone tunnel length available for implants.

CLINICAL RELEVANCE: This cadaveric anatomic study establishes safety from iatrogenic PIN injury during drilling of the bicipital tuberosity for the purpose of open or endoscopic EndoButton repair of distal biceps tendon ruptures.

Full text links

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app