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Risk Assessment of Injury to Palmar Cutaneous Branch of the Median Nerve Using High-Resolution Ultrasound.

Authors :
Jeong YH
Choi JH
Choi HS
Kang S
Yang SN
Yoon JS
Source :
Annals of rehabilitation medicine [Ann Rehabil Med] 2019 Aug; Vol. 43 (4), pp. 458-464. Date of Electronic Publication: 2019 Aug 31.
Publication Year :
2019

Abstract

Objective: To evaluate the relationship between the palmar cutaneous branch of median nerve (PCBMN) and surrounding anatomical structures by using high-resolution ultrasound (HRUS) to assess the risk of PCBMN injury.<br />Methods: The PCBMN course and the characteristics of bilateral distal forearms and wrists of 30 healthy volunteers were identified. The distance between PCBMN and other anatomical structures at three different levels along its course were measured using HRUS. Moreover, the depth of PCBMN from skin and its cross-sectional area (CSA) were measured.<br />Results: HRUS showed the PCBMN in all subjects. PCBMN branched off from the radial aspect of the median nerve (MN) at 4.69±0.89 cm proximal to the bistyloid line (BSL) and extended radially toward the flexor carpi radialis (FCR) tendon. PCBMN was within the ulnar edge of FCR tendon sheath, and became more superficial and perforated the antebrachial fascia between the FCR tendon laterally and the palmaris longus (PL) tendon medially. PCBMN was located at 4.08±0.72 mm on the ulnar aspect of the FCR tendon and 4.78±0.36 mm radially on the PL tendon at BSL. At the distal wrist crease level, the PCBMN was located at 5.68±0.58 mm on the ulnar side of the FCR tendon. The PCBMN depth from skin at BSL and its branching point was 1.92±0.41 and 7.95±0.79 mm, respectively. The PCBMN CSA was 0.26±0.15 mm2 at BSL.<br />Conclusion: HRUS can be used to identify PCBMN and its relationship with other anatomical structures. Our data can be used to predict PCBMN location, and prevent complications associated with invasive procedures involving the wrist.

Details

Language :
English
ISSN :
2234-0645
Volume :
43
Issue :
4
Database :
MEDLINE
Journal :
Annals of rehabilitation medicine
Publication Type :
Academic Journal
Accession number :
31499599
Full Text :
https://doi.org/10.5535/arm.2019.43.4.458