Variant anatomy of the radial nerve and radial artery on the forearm

According to statistics, mortality from cardiovascular diseases remains at a fairly high level in the world as a whole and in Russia, in particular, amounting to 31 and 57.1%, respectively. Despite the constant introduction of new, often minimally invasive, methods of treating coronary heart disease, a fairly large percentage of patients still have to resort to coronary artery bypass grafting. There are several options for possible autografts, one of which is the radial artery. However, when it is “taken away”, a complication is possible - damage to the superficial branch of the radial nerve, which is negatively reflected in the postoperative period on the zone of its innervation. Objective: To study the variant anatomy and topographic relationship of the radial nerve and radial artery in the forearm. Methods: 1. This study was conducted on both non-fixed and fixed cadaveric material. 2. The objects of the study were 20 corpses of people of both sexes, who died at the age of 18 to 67 years, without traumatic injuries of the upper limbs. 3. Using the method of layer-by-layer tissue preparation, the radial artery (LA) and radial nerve (LN) were isolated, and their topographic relationships were studied. 4. The study was conducted from January 2019 to February 2020. Results: Analysis of the diameter of the superficial and deep branches of the LN did not reveal significant differences on the right and left, the average value was M-2.6 ± 0.4. No unusual positioning of the radial artery was identified; the position was classical. It was found that the LN is located as close as possible to the LA in the / 3 shoulder and is located with it in the same fascial bed. The location of the nerve and artery in one fascial bed with separation by thin fibrous bridges was determined in 6 cases, which corresponds to 30%. The location of the radial artery and nerve in different fascial beds was revealed in 4 cases, which was 20%. In other cases, a parallel arrangement of the radial artery and the superficial branch of the radial nerve was revealed. The distance between them was from 3 to 5 mm. The length of the closest location was M - 2.9 ± 0.7 cm. The distance of the closest approach of the radial artery and radial nerve to each other from the medial epicondyle of the humerus was M - 8.7 ± 2.1 cm. Conclusion: The revealed features must be taken into account during operative approaches to the radial artery on the forearm.