Acromion-axillary nerve distance and its relation to the arm length in the prediction of the axillary nerve position: A clinical study

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dc.authoridErhan Bayram / 0000-0002-9426-2831en_US
dc.authorscopusidErhan Bayram / 56704760000
dc.authorwosidErhan Bayram / HJH-5360-2023en_US
dc.contributor.authorYıldırım, Cem
dc.contributor.authorDemirel, Mehmet
dc.contributor.authorBayram, Erhan
dc.contributor.authorEkinci, Mehmet
dc.contributor.authorYılmaz, Murat
dc.date.accessioned2022-05-20T11:25:17Z
dc.date.available2022-05-20T11:25:17Z
dc.date.issued2022en_US
dc.departmentİstinye Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractBackground: Because of the broad anatomic variation in the course of the axillary nerve, several cadaveric studies have investigated the acromion-axillary nerve distance and its association with the humeral length to predict the axillary nerve location. This study aimed to analyze the acromion-axillary nerve distance (AAND) and its relation to the arm length (AL) in patients who underwent internal plate fxation for proximal humerus fractures. Methods: The present prospective study involved 37 patients (15 female, 22 male; the mean age=51 years, age range 19–76) with displaced proximal humerus fractures treated by open reduction and internal fxation. After anatomic reduction and fxation were achieved, the following parameters were measured in each patient before wound closure without making an extra incision or dissection: (1) the distance from the anterolateral edge of the acromion to the course of the axillary nerve was recorded as the acromion-axillary nerve distance and (2) the distance from the anterolateral edge of the acromion to the lateral epicondyle of the humerus was recorded as arm length. The ratio of AAND to AL was then calculated and recorded as the axillary nerve index (ANI). Results: The mean AAND was 6±0.36 cm (range 5.5–6.6), and the mean arm length was 32.91±2.9 cm (range 24–38). The mean axillary nerve ratio was 0.18±0.02 (range 0.16 to 0.23). There was a signifcant moderate positive correlation between AL and AAND (p=0.006; r=0.447). The axillary nerve location was predictable in only 18% of the patients. Conclusion: During the anterolateral deltoid-splitting approach to the shoulder joint, 5.5 cm from the anterolateral edge of the acromion could be considered a safe zone to prevent possible axillary nerve injury. Keywords: Axillary nerve, Trans-deltoid approach, Deltoid-splitting approach, Iatrogenic nerve injury, Safe zoneen_US
dc.identifier.citationYildirim C, Demirel M, Bayram E, Ekinci M, Yılmaz M. Acromion-axillary nerve distance and its relation to the arm length in the prediction of the axillary nerve position: a clinical study. J Orthop Surg Res. 2022 Apr 24;17(1):248. doi: 10.1186/s13018-022-03085-6. PMID: 35462535; PMCID: PMC9036714.en_US
dc.identifier.doi10.1186/s13018-022-03085-6en_US
dc.identifier.issn0736-0266en_US
dc.identifier.pmid35462535en_US
dc.identifier.scopus2-s2.0-85128750218en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.urihttp://doi.org/10.1186/s13018-022-03085-6
dc.identifier.urihttps://hdl.handle.net/20.500.12713/2683
dc.identifier.volume17en_US
dc.identifier.wosWOS:000786443100001en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorBayram, Erhan
dc.language.isoenen_US
dc.publisherPubMeden_US
dc.relation.ispartofJournal of Orthopaedic Surgery and Researchen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAxillary Nerveen_US
dc.subjectTrans-deltoid Approachen_US
dc.subjectDeltoid-splitting Approachen_US
dc.subjectLatrogenic Nerve Injuryen_US
dc.subjectSafe Zoneen_US
dc.titleAcromion-axillary nerve distance and its relation to the arm length in the prediction of the axillary nerve position: A clinical studyen_US
dc.typeArticleen_US

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