Cadaveric and Ultrasound Validation of Percutaneous Electrolysis Approaches at the Arcade of Frohse: A Potential Treatment for Radial Tunnel Syndrome

Pedro Belón-Pérez, Laura Calderón-Díez, José Luis Sánchez-Sánchez, Miguel Robles-García, Gustavo Plaza-Manzano and César Fernández- de-las-Peñas
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Pedro Belón-Pérez: Department of Physical Therapy, Real Madrid C.F., 28055 Madrid, Spain
Laura Calderón-Díez: Department of Physical Therapy, Universidad de Salamanca, 37008 Salamanca, Spain
José Luis Sánchez-Sánchez: Department of Physical Therapy, Universidad de Salamanca, 37008 Salamanca, Spain
Miguel Robles-García: Department of Anatomy and Histology, Faculty of Medicine, Universidad de Salamanca, 37008 Salamanca, Spain
Gustavo Plaza-Manzano: Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain
César Fernández- de-las-Peñas: Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), 28922 Alcorcón, Spain

IJERPH, 2022, vol. 19, issue 4, 1-7

Abstract: Entrapment of the radial nerve at the arcade of Frohse could contribute to symptoms in patients with lateral epicondylalgia or radial tunnel syndrome. Our aim was to determine the validity of applying percutaneous electrolysis, targeting the supinator muscle at the Frohse’s arcade with ultrasound imaging and in a Thiel-embalmed cadaver model (not ultrasound-guiding). Percutaneous electrolysis targeting the supinator muscle was conducted in five healthy volunteers (ultrasound study) and three Thiel-embalmed cadaver forearms. Two approaches, one with the forearm supinated and other with the forearm pronated were conducted. The needle was inserted until the tip reached the interphase of both bellies of the supinator muscle. Accurate needle penetration of the supinator muscle was observed in 100% in both US-imaging and cadaveric studies. No neurovascular bundle of the radial-nerve deep branch was pierced in any insertion. The distance from the tip of the needle to the neurovascular bundle was 15.3 ± 0.6 mm with the forearm supinated, and 11.2 ± 0.6 mm with the forearm pronated. The results of the current study support that percutaneous electrolysis can properly target the supinator muscle with either the forearm in supination or in pronation. In fact, penetration of the neurovascular bundle was not observed in any approach when percutaneous needling electrolysis was performed by an experienced clinician.

Keywords: Frohse arcade; radial nerve; supinator; cadaver; percutaneous electrolysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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