Anatomy of the palmar cutaneous branch of the median nerve: A review

Smith, Jennifer L.; Ebraheim, Nabil A.

doi:10.1016/j.jor.2019.06.010

Cited by 21 publications

(15 citation statements)

References 13 publications

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“…The PCMN is problematic because the inter-thenar region is a common incision site and injury of the PCMN can result in considerable discomfort [15]. The PCMN has been described as a single branch originating from the radial side of the median nerve under the antebrachial fascia at the level of the distal forearm [16][17][18][19][20]. It courses superficially through the superficial transverse carpal ligament and innervates the palmar skin longitudinally along the inter-thenar crease.…”

Section: Discussionmentioning

confidence: 99%

Anatomical variations of the innervated radial artery superficial palmar branch flap: A series of 28 clinical cases

Yang¹

2020

Arch Plast Surg

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Background The innervated radial artery superficial palmar branch (iRASP) flap was designed to provide consistent innervation by the palmar cutaneous branch of the median nerve (PCMN) to a glabrous skin flap. The iRASP flap is used to achieve coverage of diverse volar defects of digits. However, unexpected anatomical variations can affect flap survival and outcomes.Methods Cases in which patients received iRASP flaps since April 1, 2014 were retrospectively investigated by reviewing the operation notes and intraoperative photographs. The injury type, flap dimensions, arterial and neural anatomy, secondary procedures, and complications were evaluated.Results Twenty-eight cases were reviewed, and no flap failures were observed. The observed anatomical variations were the absence of a direct skin perforator, large-diameter radial artery superficial palmar branch (RASP), and the PCMN not being a single branch. Debulking procedures were performed in 16 cases (57.1%) due to flap bulkiness.Conclusions In some cases, an excessively large RASP artery was observed, even when there was no direct skin perforator from the RASP or variation in the PCMN. These findings should facilitate application of the iRASP flap, as well as any surgical procedures that involve potential damage to the PCMN in the inter-thenar crease region. Additional clinical cases will provide further clarification regarding potential anatomical variations.

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Section: Discussionmentioning

confidence: 99%

Anatomical variations of the innervated radial artery superficial palmar branch flap: A series of 28 clinical cases

Yang¹

2020

Arch Plast Surg

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“…But this argument ignored the improvements made over the past 20 years to the incision itself. Thanks to anatomical studies that continue to be updated [4] , [5] , [6] , focused especially on the path of the superficial nerves and their variations, we gradually went from a long incision that started on the distal portion of the forearm to a short incision located in the palm, which did not impact the heel of the hand, a highly sensitive area. Before the widespread introduction of endoscopy, the controversies were mostly about the incision’s path on the surface with no special focus on how we crossed through the deeper layers to reach the retinaculum.…”

Section: Nd Lesson: the Hand Is Constantly The Subject Of Innovativementioning

confidence: 99%

Lessons learned during my hand surgery career

Masquelet

2021

Hand Surgery and Rehabilitation

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“…Once in the subcutaneous tissue, the nerve continues distally superficial to the transverse carpal ligament to innervate the skin of the thenar eminence. [69][70][71] The PCB of the MN can be injured from iatrogenic causes or external trauma. 72,73 Patients with an injury to the PCB of the MN present with anterior wrist pain associated with paresthesias in the palm of the hand, which can mimic symptoms of CTS.…”

Section: Posttraumatic Transection Of the Mnmentioning

confidence: 99%

“…The PCB most commonly branches from the radial side of the MN proximal to the CT and travels distally toward the subcutaneous tissue within the interval between the MN and flexor carpi radialis tendon. Once in the subcutaneous tissue, the nerve continues distally superficial to the transverse carpal ligament to innervate the skin of the thenar eminence 69‐71 . The PCB of the MN can be injured from iatrogenic causes or external trauma 72,73 .…”

Section: Lookalike Conditionsmentioning

confidence: 99%

Ultrasound Findings in Less Frequent Causes of Carpal Tunnel Syndrome

Bianchi

Hoffman

Tamborrini

et al. 2020

J of Ultrasound Medicine

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The most common etiology of carpal tunnel syndrome (CTS) is idiopathic. However, secondary causes of CTS should be considered when symptoms are unilateral, or electrodiagnostic studies are discrepant with the clinical presentation. Imaging of the carpal tunnel should be performed when secondary causes of CTS are suspected. An ultrasound evaluation of the carpal tunnel can assess for pathologic changes of the median nerve, detect secondary causes of CTS, and aid in surgical planning.

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Anatomy of the palmar cutaneous branch of the median nerve: A review

Cited by 21 publications

References 13 publications

Anatomical variations of the innervated radial artery superficial palmar branch flap: A series of 28 clinical cases

Anatomical variations of the innervated radial artery superficial palmar branch flap: A series of 28 clinical cases

Lessons learned during my hand surgery career

Ultrasound Findings in Less Frequent Causes of Carpal Tunnel Syndrome

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