Ultrasound imaging of the thenar motor branch of the median nerve: a cadaveric study.
Introduction: Anatomic variations of the median nerve (MN) increase the risk of iatrogenic injury during carpal tunnel release surgery. We investigated whether high-frequency ultrasonography could identify anatomic variations of the MN and its thenar motor branch (MBMN) in the carpal tunnel.Methods:...
| Published in: | European Radiology Vol. 27; no. 11; pp. 4883 - 4889 |
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| Main Authors: | , , , , |
| Format: | diagnostic images pictorial research tables/charts Journal Article |
| Published: |
Springer Nature
Nov2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=125580626&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125580626 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Nov2017 vid: 27 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 125580626 125580626 144120833 NLM28593429 125580626 10.1007/s00330-017-4882-0 NLM28593429 125580626 ppf: 4883 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Ultrasound imaging of the thenar motor branch of the median nerve: a cadaveric study. aug: au: Petrover, David Bellity, Jonathan Vigan, Marie Nizard, Remy Hakime, Antoine affil: Centre Imagerie Medicale Bachaumont Paris Centre (IMPC Bachaumont-Blomet Ramsay GDS) , 6 rue Bachaumont 75002 Paris France sug: subj: Median Nerve Anatomy and Histology Median Nerve Aged Carpal Tunnel Syndrome Surgery Ultrasonography Dissection Male Female Carpal Tunnel Syndrome Cadaver Wrist Human Aged: 65+ years Male Female ab: Introduction: Anatomic variations of the median nerve (MN) increase the risk of iatrogenic injury during carpal tunnel release surgery. We investigated whether high-frequency ultrasonography could identify anatomic variations of the MN and its thenar motor branch (MBMN) in the carpal tunnel.Methods: For each volar wrist of healthy non-embalmed cadavers, the type of MN variant (Lanz classification), course and orientation of the MBMN, and presence of hypertrophic muscles were scored by 18-MHz ultrasound and then by dissection.Result: MBMN was identified by ultrasound in all 30 wrists (15 subjects). By dissection, type 1, 2 and 3 variants were found in 84%, 3%, and 13% of wrists, respectively. Ultrasound had good agreement with dissection in identifying the variant type (kappa =0.9). With both techniques, extra-, sub-, and transligamentous courses were recorded in 65%, 31%, and 4% of cases, respectively. With both techniques, the bifid nerve, hypertrophic muscles, and bilateral symmetry for variant type were identified in 13.3%, 13.3%, and 86.7% of wrists, respectively. Agreement between ultrasound and dissection was excellent for the MBMN course and orientation (kappa =1).Conclusion: Ultrasound can be used reliably to identify anatomic variations of the MN and MBMN. It could be a useful tool before carpal tunnel release surgery.Key Points: • Ultrasound can identify variations of the motor branch of the median nerve. • Ultrasound mapping should be used prior to carpal tunnel release surgery. • All sub-, extra-, and transligamentous courses were accurately identified. • Type 3 variants (bifid nerve), hypertrophic muscles, and bilateral symmetry were accurately identified. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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