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. 2017 Mar 13;9(3):e1094.
doi: 10.7759/cureus.1094.

Relationship of the Median and Radial Nerves at the Elbow: Application to Avoiding Injury During Venipuncture or Other Invasive Procedures of the Cubital Fossa

Vlad Voin  1 , Joe Iwanaga  2 , Juan P Sardi  3 , Christian Fisahn  4 , Marios Loukas  5 , Rod J Oskouian  6 , R Shane Tubbs  7
Affiliations

Relationship of the Median and Radial Nerves at the Elbow: Application to Avoiding Injury During Venipuncture or Other Invasive Procedures of the Cubital Fossa

Vlad Voin et al. Cureus. .

Abstract

Introduction: The median and radial nerves are two important neural structures found in the cubital fossa. The trajectory and landmarks used to identify their location are important when procedures are done in this area.

Methods and materials: Ten fresh-frozen cadavers were dissected (20 upper limbs) and measurements were taken from the medial epicondyle to the median and radial nerves as well as to the lateral epicondyle of each limb.

Results: The distance between the medial epicondyle and the median nerve was found to be three centimeters with a range of 2.1 to four centimeters and the distance from the medial epicondyle to the radial nerve had a mean distance of 5.5 cm and a range of 3.8 to seven centimeters.

Discussion: Damage to the median or radial nerves can lead to major complications including loss of extension, flexion, and sensation in the forearm and hand. Other studies have tried to identify the course of these nerves in order to prevent their injury during procedures.

Conclusion: After identifying the medial epicondyle, using the results we obtained, physicians may have a better understanding of where the median and radial nerves lie within the cubital fossa when performing procedures in this area.

Keywords: anatomy; avoidance; complications; nerve injury; veins.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Schematic view of the right cubital fossa. Note that the distal biceps brachii muscle has been removed. In the cubital fossa, the biceps tendon is most lateral and is adjacent to the brachial artery and the more medially placed median nerve. Also note, the radial nerve entering the cubital fossa in a more lateral location compared to the median nerve
Original drawing done by David Fisher
See this image and copyright information in PMC

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