A method of radial nerve length measurement based on cadaveric investigation

Publication date: Available online 6 September 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Jae-Gyum Kim, Dasom Kim, Hung Youl Seok, Yoohwan Kim, Kyung-Sook Yang, Im Joo Rhyu, Byung-Jo Kim
ObjectiveTo determine the most reliable method to measure the length of the radial nerve during a nerve conduction study (NCS).DesignCadaveric investigationSettingA practical anatomy research laboratory in a universitySubjects10 fresh cadaversInterventionsDesign of measurement methods using cadaver dissection and compare the measured values to the true length in 18 arms of nine cadavers.Main Outcome MeasuresFour points (A, B, C, and D) were determined: A) proximal stimulation point in NCS, B) point at the elbow crease, C) point in the mid-forearm, D) distal stimulation point 5 cm above the extensor indicis (EI). The true length of the radial nerve between the stimulus points (point A and D) in NCS was compared with the measured values by summation of the straight line segments between those points with various combinations. The difference in root mean squared error of distance measured by each method compared to the true length was calculated to determine the best measurement method.ResultsThe closest distance to the true length (28.7 ± 2.8 cm) in the cadaveric investigation was obtained using the summation of straight line segments between points A, B, and D (A-B-D, RMSE = 0.72 cm) followed by the A-B-C-D distance (RMSE = 0.87 cm) and the A-D distance (RMSE = 1.38 cm) methods, in sequence. The former two distance measurements were relatively closer to the true length than the latter measurement method.ConclusionsMultiple segmentation measurement methods reflected the course of the radial nerve better than a single linear measurement method. We suggest that the distance measured using a stopover point near the lateral epicondyle between two stimulus points (A-B-D distance) is closer to the true length of the nerve.



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