Division of the sensory ramus communicans between the ulnar and median nerves

May, James W.; Hr, Rosen

doi:10.2106/00004623-198163050-00025

Cited by 55 publications

(17 citation statements)

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“…This branch usually crosses the metacarpal space distal to the superficial palmar arch, but in some cases it may cross further proximally, just distal to the edge of the transverse carpal ligament. This position makes it vulnerable to injury during carpal tunnel release (24). The hook of the hamate marks the ulnar edge of the flexor retinaculum.…”

Section: The Distal Edge Of the Carpal Tunnelmentioning

confidence: 99%

Anatomic variations of the median nerve in the carpal tunnel: a brief review of the literature

Demirçay¹,

Çivelek²,

Cansever³

et al. 2011

Turkish Neurosurgery

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Carpal tunnel syndrome (CTS) is a common focal peripheral neuropathy. Increased pressure in the carpal tunnel results in median nerve compression and impaired nerve perfusion, leading to discomfort and paresthesia in the affected hand. Surgical division of the transverse carpal ligament is preferred in severe cases of CTS and should be considered when conservative measures fail. A through knowledge of the normal and variant anatomy of the median nerve in the wrist is fundamental in avoiding complications during carpal tunnel release. This paper aims to briefly review the anatomic variations of the median nerve in the carpal tunnel and its implications in carpal tunnel surgery. KeywOrds: Median nerve, Anatomic variation, Carpal tunnel, Transverse carpal ligament ÖZKarpal tünel sendromu (KTS) sık görülen bir periferik nöropatidir. Karpal tünel basıncının artması median sinirin sıkışmasına ve kanlanmasının bozulmasına yol açar. Ağır vakalarda ve konservatif tedavinin yeterli olmadığı durumlarda cerrahi olarak transvers karpal ligamanın kesilmesi tercih edilir. Karpal tünelin gevşetilmesi sırasında komplikasyonlardan kaçınmak için median sinirin bu bölgedeki ayrıntılı anatomisinin ve varyasyonlarının iyi bilinmesi gereklidir. Bu derleme median sinirin karpal tüneldeki olası anatomik varyasyonlarını ve bunun karpal tünel cerrahisine etkilerini kısaca gözden geçirmek amacıyla yazılmıştır.

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Section: The Distal Edge Of the Carpal Tunnelmentioning

confidence: 99%

Anatomic variations of the median nerve in the carpal tunnel: a brief review of the literature

Demirçay¹,

Çivelek²,

Cansever³

et al. 2011

Turkish Neurosurgery

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“…implications of its existence and anatomic variations. May and Rosen (1981) reported on a patient with diminished sensibility on the radial side of the ring finger caused by an injury to the communicating branch during carpal tunnel surgery, and this renewed the interest in this branch as a possible cause of the variations in digital sensory patterns. Eight anatomic variations of the communicating branch have been found in 90% to 95% of cadaveric specimen (Don Ferrari and Gilbert, 1991;Meals and Shaner, 1983) and one would expect that variations in palmar sensibility patterns would be observed in a similar percentage of clinical cases.…”

Section: Discussionmentioning

confidence: 98%

Digital Innervation Patterns Following Median or Ulnar Nerve Laceration and their Correlation to Anatomic Variations of the Communicating Branch Between these Nerves

Griot

Hage

Groot

2004

Journal of Hand Surgery

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The midline of the ring finger is classically considered as the neural watershed between the median and ulnar nerve sensory territories on the palmar surfaces of the fingers. Variations of this division exist and may be explained by a communicating branch between the third and fourth common digital nerves. The palmar sensibility patterns of fingers were assessed with Semmes Weinstein filaments after either a complete median or an ulnar nerve transection in 43 patients. Eight out of nine observed sensibility patterns could be explained by known anatomic types and subtypes of the communicating branch. The type of communicating branch, but not its subtype, could be established in the one remaining pattern.

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“…[10] A communicating branch between the third common digital branch of the median nerve and the fourth common digital branch of the ulnar nerve has been described. [20,23,32] Meals and Shaner [34] found this ramus communicans in 40 of 50 hands that they dissected. This branch most commonly transmits sensory fibers from the superficial ulnar nerve into the radial digital nerve of the ring finger.…”

Section: The Distal Edge Of the Flexor Retinaculummentioning

confidence: 98%

“…Injury to the ramus communicans has been reported to occur in both OCTR and ECTR procedures. [32] An anomalous communication passing from the median to the ulnar nerve proximal to the wrist innervation, the little finger, and index finger was described by Saeed and Davies. [41] The hook of the hamate marks the ulnar edge of the distal flexor retinaculum.…”

Section: The Distal Edge Of the Flexor Retinaculummentioning

confidence: 98%