The Myth of Median Nerve in Forearm and Its Role in Double Crush Syndrome: A Cadaveric Study

Abdalbary, Sahar Ahmed; Abdel-wahed, Mohamed S.; Amr, Sherif M.; Mahmoud, Mostafa; El-Shaarawy, Ehab Aa; Salaheldin, Safinaz; Fares, Amal Elham

doi:10.3389/fsurg.2021.648779

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…In a study by Sunderland and Bradley [10], the authors reported greater thickness of the perineurium at the wrist than at the axilla for the ulnar and median nerves. In contrast, in a study by Abdalbary et al [15], greater perineurium thickness was observed in the forearm compared to the arm and wrist.…”

Section: Introductionmentioning

confidence: 61%

On the Relationship Between Fascicle Diameter and Perineurium Thickness in the Ulnar Nerve of Pigs

Andreis

Metcalfe

Janjua

et al. 2023

2023 11th International IEEE/EMBS Conference on Neural Engineering (NER)

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The anatomical structures of peripheral nerves significantly influence the performance and selectivity of neural interfaces. Among these structures, the perineurium thickness, because of its high resistivity, is important in shaping the electric field distribution within a nerve. However, data on the perineurium thickness of somatic nerves in animals is sparse. As animal models are the first step towards developing novel implantable nerve interfaces, this study characterises the perineurium thickness in the ulnar nerve of pigs. Distal and proximal sections of the ulnar nerve (n = 6) were extracted, stained with haematoxylin and eosin, and the perineurium thickness and fascicular diameters were measured. In total, 129 fascicles were quantified, and the average fascicle diameter was 269 ± 73.3 µm and 277 ± 81.1 µm for the distal and proximal nerves, respectively (p = 0.59). A linear relationship was observed between fascicle diameter and perineurium thickness (R 2 = 0.69). This relationship was affected by the location of the nerve section, with distal sections having a greater perineurium thickness than proximal segments. Finally, equations were provided to estimate the perineurium thickness based on fascicle diameter. This information can be used to develop realistic peripheral nerve models, which can reduce variability and improve the selectivity of neural interfaces.

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Section: Introductionmentioning

confidence: 61%

On the Relationship Between Fascicle Diameter and Perineurium Thickness in the Ulnar Nerve of Pigs

Andreis

Metcalfe

Janjua

et al. 2023

2023 11th International IEEE/EMBS Conference on Neural Engineering (NER)

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“…We describe it more inclusively as median nerve compression in the forearm (MNCF) ( Figure 2 ) [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. CTS is also well known to be associated with radiculopathy in the cervical spine due to a double crush phenomenon [ 24 , 25 , 26 , 27 ]. Failure to recognize a secondary site of compression can lead to incomplete resolution of symptoms.…”

Section: Etiology Of Failed Carpal Tunnel Releasementioning

confidence: 99%

Revision of Carpal Tunnel Surgery

Pripotnev

Mackinnon

2022

JCM

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Carpal tunnel release is one of the most commonly performed upper extremity procedures. The majority of patients experience significant improvement or resolution of their symptoms. However, a small but important subset of patients will experience the failure of their initial surgery. These patients can be grouped into persistent, recurrent, and new symptom categories. The approach to these patients starts with a thorough clinical examination and is supplemented with electrodiagnostic studies. The step-wise surgical management of revision carpal tunnel surgery consists of the proximal exploration of the median nerve, Guyon’s release with neurolysis, the rerelease of the transverse retinaculum, evaluation of the nerve injury, treatment of secondary sites of compression, and potential ancillary procedures. The approach and management of failed carpal tunnel release are reviewed in this article.

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“…Throughout the arm, the MN passes through many narrow structures where it may compress the nerve ( Abdalbary, Abdel-Wahed et al, 2021 ). The carpal tunnel is the most common location for MN entrapment ( Knutsen and Calfee, 2013 ; Kantarci, Ustabasioglu et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Non-invasive in vivo study of morphology and mechanical properties of the median nerve

Xu,

Ren,

Zhang

et al. 2024

Front. Bioeng. Biotechnol.

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The current literature studied the median nerve (MN) at specific locations during joint motions. As only a few particular parts of the nerve are depicted, the relevant information available is limited. This experiment investigated the morphological and biomechanical properties of the MN. The effects of the shoulder and wrist motions on MN were explored as well. Eight young healthy female individuals were tested with two-dimensional ultrasound and shear wave elastography (SWE). The morphological and biomechanical properties were examined in limb position 1, with the wrist at the neutral position, the elbow extended at 180°, and the shoulder abducted at 60°. In addition, the experiment assessed the differences among the wrist, forearm, elbow, and upper arm with Friedman’s test and Bonferroni post hoc analysis. Two groups of limb positions were designed to explore the effects of shoulder movements (shoulder abducted at 90° and 120°) and wrist movements (wrist extended at 45° and flexed at 45°) on the thickness and Young’s modulus. Differences among the distributions of five limb positions were tested as well. The ICC3, 1 values for thickness and Young’s modulus were 0.976 and 0.996, respectively. There were differences among the MN thicknesses of four arm locations in limb position 1, while Young’s modulus was higher at the elbow and wrist than at the forearm and upper arm. Compared to limb position 1, only limb position 4 had an effect on MN thickness at the wrist. Both shoulder and wrist motions affected MN Young’s modulus, and the stiffness variations at typical locations all showed a downward trend proximally in all. The distributions of MN thickness and Young’s modulus showed fold line patterns but differed at the wrist and the pronator teres. The MN in the wrist is more susceptible to limb positions, and Young’s modulus is sensitive to nerve changes and is more promising for the early diagnosis of neuropathy.

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The Myth of Median Nerve in Forearm and Its Role in Double Crush Syndrome: A Cadaveric Study

Cited by 3 publications

References 27 publications

On the Relationship Between Fascicle Diameter and Perineurium Thickness in the Ulnar Nerve of Pigs

On the Relationship Between Fascicle Diameter and Perineurium Thickness in the Ulnar Nerve of Pigs

Revision of Carpal Tunnel Surgery

Non-invasive in vivo study of morphology and mechanical properties of the median nerve

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