Sonographic Visualization of Thenar Motor Branch of the Median Nerve: A Cadaveric Validation Study

Smith, Jay; Barnes, Darryl E.; Barnes, Kailee J.; Strakowski, Jeffrey A.; Lachman, Nirusha; Martinoli, Carlo

doi:10.1016/j.pmrj.2016.05.008

Cited by 20 publications

(21 citation statements)

References 58 publications

(135 reference statements)

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“…Furthermore, a recently published level 1 prospective randomized controlled trial comparing mini‐open CTR (n = 41) with USCTR (n = 41) using a hook knife reported a 5‐time faster functional recovery and pain medication discontinuation with USCTR [4]. In addition to faster recovery, US provides an additional safety factor by visualizing of space‐occupying lesions and at‐risk structures, such as gouty tophi, ganglia, lipomas, fibromas, persistent median arteries, accessory muscles, and the palmar cutaneous and thenar motor branches of the median nerve [16,22,23]. Because of the ability to identify these at risk or aberrant structures before any procedures, USGCTR is potentially safer than traditional releases [16,24].…”

Section: Discussionmentioning

confidence: 99%

Sonographic Changes After Ultrasound‐Guided Release of the Transverse Carpal Ligament: A Case Report

Latzka

Henning

Pourcho

2018

PM&R

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Carpal tunnel syndrome is the most common entrapment neuropathy, resulting in 500,000 carpal tunnel release (CTR) surgeries and a total cost of more than 2 billion dollars annually in the United States. Although initially performed via a large (3-5 cm) palmar incision, CTR techniques have continually evolved to reduce incision size, recovery times, postoperative pain, and improve cosmesis and clinical outcomes. More recently, multiple authors have reported excellent results after ultrasound-guided carpal tunnel release (USCTR) using a variety of techniques, and one prospective randomized trial reported faster recovery after USCTR compared with traditional mini-open CTR. However, there is a paucity of data with respect to changes in the median nerve after USCTR. This case report presents the functional outcomes and pre- and postprocedure ultrasound images of a patient after USCTR with 3-month follow-up. LEVEL OF EVIDENCE: V.

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Section: Discussionmentioning

confidence: 99%

Sonographic Changes After Ultrasound‐Guided Release of the Transverse Carpal Ligament: A Case Report

Latzka

Henning

Pourcho

2018

PM&R

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“…This technique has resulted in a reduction in morbidity and an acceleration in recovery time due to the smaller incision size. 8 Transection of the retinaculum takes place after introduction of an endoscope with a retractable blade through a 1.5-to 2-cm incision in the wrist flexion crease. A break from work and daily activities of around 2 to 3 weeks is then recommended.…”

Section: Endoscopic Proceduresmentioning

confidence: 99%

“…Several studies have recently demonstrated the interest of ultrasound-guided transection of the retinaculum. [2][3][4][5][6][7] This technique has the advantages of (1) great safety, due to continuous ultrasound monitoring and visualization of variants of the median nerve, [8][9][10] and (2) a decrease in size of the incision, enabling a more rapid return to work and a more aesthetic scar. 6,11 Percutaneous access by ultrasound-guided surgery (UCTR) is, at least, 10 times smaller than with classical surgical techniques.…”

Section: Ultrasound-guided Surgerymentioning

confidence: 99%

Ultrasound-Guided Surgery for Carpal Tunnel Syndrome: A New Interventional Procedure

Petrover¹,

Hakimé²,

Silvera

et al. 2018

Semin intervent Radiol

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Carpal tunnel syndrome (CTS) may be treated surgically if medical treatment fails. The classical approach involves release of the flexor retinaculum by endoscopic or open surgery. Meta-analyses have shown that the risk of nerve injury may be higher with endoscopic treatment. The recent contribution of ultrasound to the diagnosis and therapeutic management of CTS opens new perspectives. Ultrasound-guided carpal tunnel release via a minimally invasive approach enables the whole operation to be performed as a percutaneous radiological procedure. The advantages are a smaller incision compared with classical techniques; great safety during the procedure by visualization of anatomic structures, particularly variations in the median nerve; and realization of the procedure under local anesthesia. These advantages lead to a reduction in postsurgical sequelae and more rapid resumption of daily activities and work. Dressings are removed by the third day postsurgery. Recent studies seem to confirm the medical, economic, and aesthetic benefits of this new approach.

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“…The small motor branch of the median nerve arises at the level of the carpal tunnel and provides innervation to the muscles of the thenar eminence. Its US appearance has been recently described . Due to its variable origin, the nerve can be injured during a carpal tunnel release.…”

Section: Pathologic Us Findingsmentioning

confidence: 99%

“…Its US appearance has been recently described. [37][38][39] Due to its variable origin, the nerve can be injured during a carpal tunnel Figure 19. Complete section of the radial collateral nerve of the thumb after surgical treatment of trigger thumb syndrome.…”

Section: After Surgerymentioning

confidence: 99%

Ultrasound Imaging of Disorders of Small Nerves of the Extremities: Less Recognized Locations

Bianchi¹,

Becciolini²,

Urigo³

2019

J of Ultrasound Medicine

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Ultrasound is a well‐proven imaging modality for showing peripheral nerve disorders and guiding perineural injections. The aim of this review is to focus on small peripheral nerve abnormalities, which are usually not recognized by sonologists. In fact, most of these small nerves have a tiny diameter (<2 mm), and their anatomy is less familiar. We describe the most common causes of small peripheral nerve disorders, providing an accurate description of their anatomic locations and relationships with adjacent structures; we also focus on technical hints that may help in their evaluation.

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Sonographic Visualization of Thenar Motor Branch of the Median Nerve: A Cadaveric Validation Study

Abstract: IV.

Cited by 20 publications

References 58 publications

Sonographic Changes After Ultrasound‐Guided Release of the Transverse Carpal Ligament: A Case Report

Sonographic Changes After Ultrasound‐Guided Release of the Transverse Carpal Ligament: A Case Report

Ultrasound-Guided Surgery for Carpal Tunnel Syndrome: A New Interventional Procedure

Ultrasound Imaging of Disorders of Small Nerves of the Extremities: Less Recognized Locations

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