The Morphometric Measurements of Median and Anterior Interosseous Nerve in Entrapment Syndromes in South Indian Population – An Anatomical Guide

Abstract

Aim: To study the parameters that can help release the median nerve and its branch, the anterior interosseous nerve from entrapment neuropathies and various other lesions warranting surgical correction and infective and traumatic disorders of adjacent structures of the region. Materials and methods: Sixty four upper limbs belonging to South-Indian population were carefully dissected using the Cunningham’s Manual of Practical Anatomy, the axillary region was exposed, the cords of brachial plexus were traced and median nerve was identified with its relation to axillary artery. The upper limbs used were all disarticulated. The median nerve was further traced and exposed in the arm and forearm. Acromion process and medial epicondyle were considered as prominent bony landmarks for median and anterior interosseous nerves respectively. Measurements were taken using a non-stretchable thread and scale with the arm consistently placed in supine position. Results: The formation of the median nerve by the union of the lateral and medial roots was 11.83±2.36 cm and 11.58±2.057 cm on the right and left sides respectively located distal to the acromion process. The distance between the origin of the anterior interosseous nerve and the medial epicondyle was 8.946±1.084 cm on the right side and 8.875±1.109 cm on the left side. Conclusion: The knowledge of the level of union of two roots of median nerve and the origin of anterior interosseous nerve can be of use to surgeons and anatomists while marking the median nerve on the surface and also releasing the median and anterior interosseous nerves to relieve from various entrapment syndromes. The present study provides data that can facilitate easy identification of the prominent landmarks of the nerve during surgical procedures.