The superficial anatomical landmarks are not reliable for predicting the recurrent branch of the median nerve.

Purpose: The variability of the recurrent branch (RB) of the median nerve lends itself to an increased risk of injury when performing the minimally invasive approach for carpal tunnel release without its direct visualization. This risk is less so when it is released via the more invasive open approa...

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Publicado en:Surgical & Radiologic Anatomy Vol. 42; no. 8; pp. 939 - 944
Autores principales: Kunc, Vojtech, Štulpa, Michal, Feigl, Georg, Neblett, Carlos, Kunc, Vladimír, Kachlík, David
Formato: Journal Article
Publicado: Springer Nature Aug2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2020
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00276-020-02475-x
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        atl: The superficial anatomical landmarks are not reliable for predicting the recurrent branch of the median nerve.
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        au:
          Kunc, Vojtech
          Štulpa, Michal
          Feigl, Georg
          Neblett, Carlos
          Kunc, Vladimír
          Kachlík, David
        affil: Department of Anatomy, Second Faculty of Medicine, Charles University, V Úvalu 84, Motol, 150 06, Prague, Czech Republic
      sug:
      ab: Purpose: The variability of the recurrent branch (RB) of the median nerve lends itself to an increased risk of injury when performing the minimally invasive approach for carpal tunnel release without its direct visualization. This risk is less so when it is released via the more invasive open approach as the RB can be easily identified, but the drawback is that of longer postoperative patient recovery time. Therefore, performing these releases via the less invasive approach should be more favorable for patients providing it could be done safely. Hence with there being a positive link between the hypertrophy of the thenar musculature and the course of RB according to previous studies. Methods: We dissected 28 hands of 14 donated bodies fixed using Thiel's method to try to demonstrate these findings of the associations among the RB, palmar creases and other superficial anatomical landmarks. Fisher's exact test was conducted to verify the relationship between those structures statistically. Results: Statistically significant links were found between the type of the RB and the type of the palmar creases (p value = 0.0094) and between the RB type and the palmaris longus muscle presence (p value = 0.028). Conclusion: It was inferred that palmar creases and other superficial anatomical landmarks listed in the text could not be used to predict the variability of the RB and the choice of mini-invasive approach should not be based on their course.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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