The branching pattern of the superficial branch of the radial nerve: Description of a third branching type

In emergency medicine, damage to the superficial branch of the radial nerve (SBRN) is often seen in patients with distal radius fractures. Knowledge of the complex SBRN anatomy is paramount in recognizing nerve damage after distal radius fractures, or in preventing iatrogenic damage during surgical reconstruction. The SBRN is also known for its involvement in difficult, therapyresistant neuropathic pain syndromes (3-5%). Therefore the SBRNhas been the subject of interest for many researchers. In 20 embalmed arms, the SBRN was dissected and categorized, and the course in each arm was mapped. Furthermore, the distance from the point where the SBRN emerges from under the deep fascia and lister's tuberculum was measured. The point at which the SBRN emerged from under the Brachioradialis muscle (BR) was consistently located at 33% of the forearm. Furthermore, three distinct branchingpatterns of the SBRN were identified: Pattern 1 (N=10) and pattern 2 (N=5) have previously been described in theliterature. In pattern 3 (N=5), two branches run a course to the radial and ulnar aspects of the thumb. The third and fourth branches run a course to the index finger, and the fifth branch runs a course to the middle finger.Despite the fact that the course of the SBRN is well defined in current literature, the SBRN is still one ofthe most damaged nerves in the human body. The discovery of a third pattern, not previously reported in detail, could help in the early identification of SBRN lesions and in the prevention of iatrogenic damage.