A rare variant of the median nerve as a reminder of the patient uniqueness

Abstract

ObjectiveDespite the wealth of data concerning anatomical variation of the median nerve, it remains important to continue describing rare variations as they arise. This study represents a unique variation of the median nerve in the human forearm.Methods32 upper limbs of 16 embalmed cadavers were utilized using anatomical dissections.ResultsThe median nerve in a right forearm of a 61 year old male cadaver followed the pathway seen in the majority of cases except during the course within the epimysium of the deep surface of Flexor Digitorum Superficialis (FDS). About half way down the muscle belly, a substantial branch equal in diameter to the main trunk of the median nerve, branched off the main trunk and perforated the FDS muscle. This variant branch continued distally within the FDS muscle belly, until it reached the distal third of forearm. Then, this aberrant branch reunited with the main trunk of the median nerve as it emerged on the lateral aspect of the distal tendon of FDS (7.4cm distally from the branch point at a level 2.5cm proximal to the pisiform bone).ConclusionThe unique variation described in this study was not found to be described in the literature. It is a reminder of the concept of patient uniqueness and the need for individualization of medical, manual, and surgical treatments offered to patients.