Histological and ultrasonographical study of the human superficial branch of the radial nerve at distal forearm and its clinical implications

Purpose: Age as poor prognostic factor following nerve repair may be due to change in intraneural anatomy with age. The purpose of this study is to find out the cross sectional microanatomy of the superficial branch of radial nerve (SBRN) at distal part of forearm for changes in the fascicular, non-fascicular components with respect to age and also to find cross section area of SBRN in healthy volunteers. Material and Methods: Sixty fresh human (37-88-year-old) cadaveric SBRN were collected from the distal part of forearm and studied at different magnifications after histological processing for morphometric analysis - total cross-sectional (Asc), fascicular (Af) and non-fascicular area (Anonf). Fifteen volunteers SBRN cross sectional area was measured by ultrasonography (US). Results: The SBRN was found to have 6-12 fascicles. Morphometric and correlation analysis confirmed that there was a significant increase of total cross section area, with significant increase of interfascicular adipose tissue in relation to advancing age. Ultrasonographic cross-sectional area ranged from 2 to 3.3 mm2. Conclusions: Our study revealed comparatively more adipose tissue in human SBRN with advancing age. These findings may help to explain poor prognosis with advancing age following repair. SBRN ultrasonographical Asc was comparable to histological Asc. Further, it is possible to find Asc of SBRN by non-invasive US study and calculate the fascicular and non-fascicular area using our histological findings.