Anatomy of the palmar cutaneous branch of the median nerve: Clinical significance

DaSilva, Manuel F.; Moore, Douglas C.; Weiss, Arnold‐Peter C.; Akelman, Edward; Sikirica, Michael

doi:10.1016/s0363-5023(96)80018-9

Cited by 92 publications

(62 citation statements)

References 7 publications

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“…25,29 For these reasons the endoscopic approaches were developed. DaSilva et al 9 showed that endoscopic surgery saves unmyelinated nerve fibers at the interthenar fold. These fibers derive from the cutaneous palmar branches of the median nerve, located in the loose connective tissue that is situated superficial to flexor reti- naculum.…”

Section: Discussionmentioning

confidence: 99%

The double tunnels technique: an alternative minimally invasive approach for carpal tunnel syndrome

Vanni

Sirabella

Galzio

et al. 2015

JNS

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OBJECT The purpose of this study was to assess the effectiveness and safety of an alternative minimally invasive technique for the treatment of carpal tunnel syndrome (CTS). METHODS This was designed as a prospective, randomized, open-label, blinded end point evaluation (PROBE) study. The active comparison was double tunnels technique (DTT) (Group A, 110 patients) versus standard open decompression of the median nerve (control [Group B], 110 patients). Patient recruitment started in January 2011. The primary outcomes were the functional Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) scores and visual analog scale (VAS) scores for pain (pVAS) at Weeks 2 and 4, and at Months 3, 6, and 12. The secondary outcome was the aesthetics (aVAS) score at Weeks 2 and 4, and at Months 3, 6, and 12. RESULTS The Student t-test and ANOVA were used, and the results were considered statistically significant if the p value was ≤ 0.05 for continuous variables. The DTT is a tissue-sparing approach that allows the surgeon to limit the length of the incision (0.6 ± 0.05 cm) and to respect the palmar fascia and the subcutaneous tissue. Recovery from wrist pain, night pain, numbness, stiffness, and weakness was achieved more effectively and quickly compared with the standard approach. Better BCTSQ, pVAS, and aVAS scores were observed in Group A. CONCLUSIONS The DTT is a safe and effective approach for the treatment of CTS. This technique entails faster recovery times, better aesthetic outcomes, and lower risks of complications.

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Section: Discussionmentioning

confidence: 99%

The double tunnels technique: an alternative minimally invasive approach for carpal tunnel syndrome

Vanni

Sirabella

Galzio

et al. 2015

JNS

View full text Add to dashboard Cite

show abstract

“…The theoretical advantage of endoscopic surgery derives from some anatomic considerations. DaSilva et al 25 showed that endoscopic surgery avoids unmyelinated nervous fibers at the interthenar crease, in the superficial loose connective tissue palmar to the flexor retinaculum. These fibers derive from the palmar cutaneous branch of the median nerve.…”

Section: Discussionmentioning

confidence: 99%

Mini-Open Blind Procedure Versus Limited Open Technique for Carpal Tunnel Release: A 30-Month Follow-Up Study

Cellocco

Rossi

Bizzarri

et al. 2005

The Journal of Hand Surgery

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“…5,6,20,21) The palmar cutaneous branch of the median nerve lies close to the FCR sheath and various anatomical variations in its origin and course render it vulnerable to injury during surgical approaches in this area. 5,10,11,13,14,[22][23][24][25] The most common manifestations of a PCBMN injury in our series were parasthesiae, hypoaesthesia or anaesthesia in the distribution of the nerve coupled with pain on extension of the wrist. Two patients with numbness as the predominant symptom improved without surgery.…”

Section: )mentioning

confidence: 63%

Iatrogenic Injuries of the Palmar Branch of the Median Nerve Following Volar Plate Fixation of the Distal Radius

Samson

Power

2017

J Hand Surg Asian-Pac Vol

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Background: Our aims were to identify iatrogenous injuries to the palmar branch of the median nerve sustained during volar plate fixation of the distal radius, make the clinician aware of this relatively uncommon complication of distal radius fixation, to emphasise common threads in symptomatology and to propose an algorithm for evaluation and management. Methods: Retrospectively interrogating our database over a 5 year period, the case records, neurophysiology records, operative records, therapy records were reviewed. The data was analysed with regard to the grade of surgeon performing the procedure, the site of injury, complexity of the fracture, delay to surgery, implant choice and outcome of the treatment. Variations in nerve anatomy were documented during revision surgery and common themes in symptomatology and clinical presentation were identified. Results: Seven patients with an iatrogenic injury involving the palmar branch of the median nerve associated with volar plate fixation of the distal radius were assessed. The male: female ratio was 1:6 and the mean age of patients was 47.8 years (33-74 years). The initial operative fixation was undertaken by a consultant orthopaedic surgeon at a mean of 7.8 (1-17) days from injury. The mean time from fracture fixation surgery to referral to the peripheral nerve injury service was 8.9 (2-36) months. Six patients presented with pain on attempted wrist extension. Five patients had parasthesia, hyperaesthesia or dysaesthesia in the distribution of the PCBMN. Anaesthesia or hypoaesthesia was present in three patients. Two patients presented with symptoms of complex regional pain syndrome (CRPS) Type 2. Conclusions: Revising relevant anatomy and possible variations as well as careful placements of retractors in the region of the median nerve could bring down these injuries. We propose an algorithm for their management.

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Anatomy of the palmar cutaneous branch of the median nerve: Clinical significance

Cited by 92 publications

References 7 publications

The double tunnels technique: an alternative minimally invasive approach for carpal tunnel syndrome

The double tunnels technique: an alternative minimally invasive approach for carpal tunnel syndrome

Mini-Open Blind Procedure Versus Limited Open Technique for Carpal Tunnel Release: A 30-Month Follow-Up Study

Iatrogenic Injuries of the Palmar Branch of the Median Nerve Following Volar Plate Fixation of the Distal Radius

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