A coexisting anatomical variation of median and ulnar nerves in a cadaver palm

• Autorzy: Natsis K. , Karanassos M. T. , Papathanasiou E. , Noussios G.
• Języki publikacji: EN

Abstrakty

EN

During a routine dissection we observed an anatomical variation of the median nerve and an atypical anastomosis in the palm region of a male cadaver. There were four distinct recurrent motor branches of the left median nerve, and the palmar cutaneous branch of the ulnar nerve communicated directly with the third common palmar digital nerve. The presence of such an anatomical variant in the hand should keep surgeons alert in the management of hand pathology especially in carpal tunnel syndrome, which is a routine operation for many medical centres. (Folia Morphol 2012; 71, 4: 269–274)

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2012
• Tom: 71
• Numer: 4
• Opis fizyczny: p.269-274,fig.,ref.

Twórcy

autor

Natsis K.

• Department of Anatomy, Medical School, Aristotle University of Thessaloniki, P.O. Box: 300, 541 24 Thessaloniki, Greece

autor

Karanassos M. T.

• Department of Anatomy, Medical School, Aristotle University of Thessaloniki, P.O. Box: 300, 541 24 Thessaloniki, Greece

autor

Papathanasiou E.

• Department of Anatomy, Medical School, Aristotle University of Thessaloniki, P.O. Box: 300, 541 24 Thessaloniki, Greece

autor

Noussios G.

• Department of Anatomy, Medical School, Aristotle University of Thessaloniki, P.O. Box: 300, 541 24 Thessaloniki, Greece

Bibliografia

• 1. Adachi B (1928) Das arteriensystem der Japaner. Maruzen, Kyoto.
• 2. Ahn DS, Yoon ES, Koo SH, Park SH (2000) A prospective study of the anatomic variations of the median nerve in the carpal tunnel in Asians. Ann Plast Surg, 44: 282–287.
• 3. Ajmani ML (1996) Variations in the motor nerve supply of the thenar and hypothenar muscles of the hand. J Anat, 189: 145–150.
• 4. Al-Qattan MM (2010) Variations in the course of the thenar motor branch of the median nerve and their relationship to the hypertrophic muscle overlying the transverse carpal ligament. J Hand Surg Am, 35: 1820–1824.
• 5. Alp M, Marur T, Akkin SM, Yalcin L, Demirci S (2005) Ramification pattern of the thenar branch of the median nerve entering the thenar fascia and the distribution of the terminal branches in the thenar musculature anatomic cadaver study in 144 hands. Clin Anat, 18: 195–199.
• 6. Amadio PC (1988) Anatomic variations of the median nerve within the carpal tunnel. Clin Anat, 1: 23.
• 7. Arey LB (1965) Developmental anatomy: a textbook and laboratory manual of embryology 7th Ed. W.B. Saunders Company, Philadelphia and London.
• 8. Bande S, De Smet L, Fabry G (1994) The results of carpal tunnel release: open versus endoscopic technique. J Hand Surg Br, 19: 14–17.
• 9. Bruce J, Walmsleyr, Ross J (1964) Manual of surgical anatomy. Livingstone, Edinburgh.
• 10. Beheiry EE (2004) Anatomical variations of the median nerve distribution and communication in the arm. Folia Morphol, 63: 313–318.
• 11. Beris AE, Likissas MG, Kontogeorgakos VA, Vekris MD, Korompilias AV (2008) Anatomic variations of the median nerve in carpal tunnel release. Clin Anat, 21: 514–518.
• 12. Bennett JB, Crouch CC (1982) Compression syndrome of the recurrent motor branch of the median nerve. J Hand Surg Am, 71: 407–409.
• 13. Beredjiklian PK, Bozentka DJ, Leung YL, Monaghan BA (2004) Complications of wrist arthroscopy. J Hand Surg Am, 29: 406–411.
• 14. Dogan UN, Uysal II, Seker M (2008) The communications between the ulnar and median nerves in upper limb. Neuroanatomy, 8: 15–19.
• 15. Entin MA (1968) Carpal tunnel syndrome and its variants. Surg Clin North Am, 48: 1097–1112.
• 16. Graham WP (1973) Variations of the motor branch of the median nerve at the wrist. Plast Reconstr Surg, 51: 90–92.
• 17. Standring S ed. (2005) Gray’s anatomy: the anatomical basis of clinical practice. 39th Ed. Churchill Livingstone. Edinburgh.
• 18. Herskovitz S, Strauch B, Gordon M (1992) Shiatsu massage-induced injury of the median recurrent motor branch (letter). Muscle Nerve, 15: 1215.
• 19. Hurwitz PJ (1996) Variations in the course of the thenar motor branch of the median nerve. J Hand Surg Br, 21: 3: 344–346.
• 20. Jensen TT (1990) Isolated compression of the motor branch of the median nerve by a ganglion. Scand J Plast Reconstr Surg, 24: 171.
• 21. Johnson RK, Shrewsbury MM (1970) Anatomical course of the thenar branch of the median nerve-usually in a separate tunnel through the transverse carpal ligament. J Bone Joint Surg Am, 52: 269–273.
• 22. Josty I, Sykes P (2001) An unusual schwannoma of the median nerve: effects on the motor branch. Br J Plast Surg, 54: 71–73.
• 23. Kato H, Ogino T, Nanbu T, Nakamura K (1991) Compression neuropathy of the motor branch of the median nerve caused by palmar ganglion. J Hand Surg Am, 16A: 751–752.
• 24. Kimura I, Ayyar DR, Lippmann SM (1983) Electrophysiological verification of the ulnar to median nerve communications in the hand and forearm. Tohoku J Exp Med, 141: 269–274.
• 25. Kobayashi N, Koshino T, Nakazawa A, Saito T (2001) Neuropathy of motor branch of median or ulnar nerve induced by midpalm ganglion. J Hand Surg, 26A: 474–477.
• 26. Kozin SH (1998) The anatomy of the recurrent branch of the median nerve. J Hand Surg Am, 23: 852–858.
• 27. Lanz U (1977) Anatomical variations of the median nerve of the carpal tunnel. J Hand Surg Am, 2: 44–53.
• 28. Lewis WH (1902) The development of the arm in man Am J Anat, 1: 145–183.
• 29. Loukas M, Bellary SS, Tubbs RS, Shoja MM, Cohen Gadol AA (2011) Deep palmar communications between the ulnar and median nerves. Clin Anat, 24: 197–201.
• 30. Loukas M, Abel N, Tubbs RS, Matusz P, Zurada A, Cohen-Gadol AA (2011) Neural interconnections between the nerves of the upper limb and surgical implications. J Neurosurg, 114: 225–235.
• 31. Mackinnon SE, Dellon AL (1988) Anatomic investigations of nerves at the wrist: I. Orientation of the motor fascicle of the median nerve in the carpal tunnel. Ann Plast Surg, 21: 32–35.
• 32. Mizia E, Klimek-Piotrowska W, Walocha J, Rutowski R, Wojtala R (2011) The median nerve in the carpal tunnel. Folia Morphol, 70: 41–46.
• 33. Mondelli M, Baldasseroni A, Aretini A, Ginanneschi F, Padua L (2010) Prevalent involvement of thenar motor fibres in vineyard workers with carpal tunnel syndrome. Clin Neurophysiol, 121: 1251–1255.
• 34. Mumford J, Morecraft R, Blair WF (1987) Anatomy of the thenar branch of the median nerve. J Hand Surg Am, 12A: 361–365.
• 35. Natsis K, Iordache G, Gigis I, Kyriazidou A, Lazaridis N, Noussios G, Paraskevas G (2009) Persistent median artery in the carpal tunnel: anatomy, embryology, clinical significance, and review of the literature. Folia Morphol, 68: 193–200.
• 36. Olave E, Prates JC, Del Sol M, Sarmento A, Gabrielli C (1995) Distribution patterns of the muscular branch of the median nerve in the thenar region. J Anat, 186: 441–446.
• 37. Olave E, Prates JC, Gabrielli C, Pardi P (1996) Short report morphometric studies of the muscular branch of the median nerve. J Anat, 189: 445–449.
• 38. Repaci M, Torrieri F, Di Blasio F, Uncini A (1999) Exclusive electrophysiological motor involvement in carpal tunnel syndrome. Clin Neurophysiol, 110: 1471–1474.
• 39. Homma T, Sakai T (1992) Thenar and hypothenar muscles and their innervation by the ulnar and median nerves in the human hand. Acta Anat (Basel), 145: 44–49.
• 40. Tagil SM, Bozkurt MC, Ozçakar L, Ersoy M, Tekdemir I, Elhan A (2007) Superficial palmar communications between the ulnar and median nerves in Turkish cadavers. Clin Anat, 20: 795–798.
• 41. Tate DE (2006) Isolated fascial compression of the recurrent motor branch of the median nerve: a case report. Hand (NY), 1: 102–105.
• 42. Tountas CP, Bihrle DM, MacDonald CJ, Bergman RA (1987) Variations of the median nerve in the carpal canal. J Hand Surg, 12A: 708–712.
• 43. Tubbs RS, Salter EG, Sheetz J, Zehren S, Lee DH, Oakes J, Oakes WJ (2005) Novel surgical approach to the carpal tunnel: cadaveric feasibility study. Clin Anat, 18: 350–356.
• 44. Widder S, Shons A (1988) Carpal tunnel syndrome associated with extra tunnel vascular compression of the median nerve motor branch. J Hand Surg Am, 13: 926–927.
• 45. Wolf AW, Packard S, Chow JC (1993) Transligamentous motor branch of the median nerve discovered during endoscopically assisted carpal tunnel release. Arthroscopy, 9: 222–223.
• 46. Yamanaka K, Horiuchi Y, Yabe Y (1994) Compression neuropathy of the motor branch of the median nerve due to an anomalous thenar muscle. J Hand Surg Br, 19: 711–712.