Relationship between the Branching Patterns of the Radial Nerve and Supinator Muscle

Abstract

The posterior interosseous nerve (PIN) innervates the posterior compartment muscle of the forearm and is a continuation of the deep branch of the radial nerve. The anatomic descriptions of PIN vary among different authors. This study investigated the distribution patterns of PIN and its relationships to the supinator muscle. This study investigated which nerves innervate the posterior compartment muscles of the forearm, the radial nerve, and the PIN, using 28 nonembalmed limbs. Also, the points where the muscle attaches to the bone were investigated. The measured variables in this study were measured from the most prominent point of the lateral epicondyle of the humerus (LEH) to the most distal point of the radius styloid process. For each specimen, the distance between the above two points was assumed to be 100%. The measurement variables were the attachment area of the supinator and branching points from the radial nerve. The attachment points of the supinator to the radius and ulna were $47.9\%\pm 3.6\%$ and $31.5\%\pm 5.2\%$ , respectively, from the LEH. In 67.9% of the specimens, the brachioradialis and extensor carpi radialis longus (ECRL) were innervated by the radial nerve before superficial nerve branching, and the extensor carpi radialis brevis (ECRB) innervated the deep branch of the radial nerve. In 21.4% of the limbs, the nerve innervating the ECRB branched at the same point as the superficial branch of the radial nerve, whereas it branched from the radial nerve in 7.1% of the limbs. In 3.6% of the limbs, the deep branch of the radial nerve branched to innervate the ECRL. PIN was identified as a large branch without divisions in 10.7% and as a deep branch innervating the extensor digitorum in 14.3% of the limbs. The anatomic findings of this study would aid in the diagnosis of PIN syndromes.