The topographic features of the fascicular groups of the median nerve in the upper arm and its clinical significance

Abstract

Objective To provide anatomical data for repair of important branches of the median nerve and for nerve transfer using part of the median nerve in the upper arm. Methods 34 upper limbs of human cadavers were used. Microanatomical dissection of the median nerve was done to observe the distribution of fascicular groups of the median nerve in the upper arm. Results In the distal two - thirds of the upper arm, branches of the median nerve constantly formed three fascicular groups. The anterior part of nerve trunk hosted branches to the pronator teres (PT) and the flexor carpi radialis (FCR). The posterior part of nerve trunk contained the anterior interosseous nerve (AIN) and branches to the palmaris longus muscle (PL). Branches to the hand and to the flexor digitorum superficialis (FDS) which was the main trunk of the median nerve at the proximal forearm were grouped to form the middle part. Conclusions The fascicular group to PT, FCR, PL and AIN can be separated from median nerve in the distal two - thirds of the upper arm, and thereby be selectively repaired and transfered. The distribution of intraneural fascicular groups should be concerned when partial transfer of median nerve in the upper arm was done.