Abstract
Introduction: Median nerve is called labourers nerve as it supplies large flexor muscles of forearm and five intrinsic muscles of hand which help in movement of the thumb. Comprehensive knowledge pertaining to its variations is extremely important in clinical and surgical procedures so as to avoid injury to it. The precise knowledge of level of origin of muscular branches of median nerve is essential in free muscular transfers to restore the mobility of fingers after trauma and to prevent the complications during the carpal tunnel decompression. Objective: In present study the objectives are to know the branching pattern of median nerve at carpal tunnel and its variations. Materials and Methods: The study included 51 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. The specimens fixed in 10% formalin were finely dissected and median nerve was traced for branching pattern at carpal tunnel. Results: Out of 51 human cadaver specimens, thenar branch of median nerve originated at three different sites, median nerve divided into medial and lateral trunks at different levels with respect to flexor retinaculum, communicating branch between ulnar and median nerve was observed, third lumbrical and adductor pollicis received branches from median nerve. Conclusion: In the present study an attempt is made to know the possible variations of median nerve branching pattern and termination in carpal tunnel so as to provide additional information which may help to decrease the risk of diagnostic and operative complications.
Highlights
Median nerve is called labourer’s nerve as it supplies large flexor muscles of forearm and five intrinsic muscles of hand whi ch help in movement of the thumb
The median nerve passes deep to flexor retinaculum in the carpal tunnel gives off thenar branch of median nerve to supply thenar group of muscles and the median nerve divides into medial and lateral trunks to supply palm and digits along with lateral two lumbricals.2Manual skill is important in many professional activities and a large proportion of industrial accidents result in total or partial impairment of function in the hand
An understanding of the structure of the hand is crucial for those involved in reparative and rehabilitative procedures.3The present study aims to study the level of origin of thenar branch of median nerve, division of the median nerve with respect to fle xor retinaculum, communicating branches between ulnar and median nerve in hand and other muscular branches from median nerve in hand
Summary
Median nerve is called labourer’s nerve as it supplies large flexor muscles of forearm and five intrinsic muscles of hand whi ch help in movement of the thumb. Results: Out of 51 human cadaver specimens, thenar branch of median nerve originated at three different sites, median nerve divided into medial and lateral trunks at different levels with respect to flexor retinaculum, communicating branch between ulnar and median nerve wa s observed, third lumbrical and adductor pollicis received branches from median nerve. The median nerve passes deep to flexor retinaculum in the carpal tunnel gives off thenar branch of median nerve to supply thenar group of muscles and the median nerve divides into medial and lateral trunks to supply palm and digits along with lateral two lumbricals.2Manual skill is important in many professional activities and a large proportion of industrial accidents result in total or partial impairment of function in the hand. An understanding of the structure of the hand is crucial for those involved in reparative and rehabilitative procedures.3The present study aims to study the level of origin of thenar branch of median nerve, division of the median nerve with respect to fle xor retinaculum, communicating branches between ulnar and median nerve in hand and other muscular branches from median nerve in hand
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