Transfer of the Dorsal Cutaneous Branch of the Ulnar Nerve for Restoration of Median Nerve Sensation: A Cadaveric Study

2018 ◽  
Vol 31 (7) ◽  
pp. 1006-1012
Author(s):  
T. David Luo ◽  
Michael D. Wigton ◽  
Benjamin W. Berwick ◽  
Mario Khalil ◽  
Wayne A. Chen ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Cadaveric Study ◽  
Cutaneous Branch

Distal nerve transfer from the median nerve lumbrical fibers to the distal ulnar nerve motor branches in the palm: An anatomical cadaveric study

Microsurgery ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 434-440
Author(s):  
Michele R. Colonna ◽  
Davide Pino ◽  
Bruno Battiston ◽  
Francesco Stagno d'Alcontres ◽  
Konstantinos Natsis ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Nerve Transfer ◽  
Cadaveric Study ◽  
Distal Nerve

Anatomy of the palmar branch of the ulnar nerve: application to ulnar and median nerve decompressive surgery

2011 ◽  
Vol 114 (1) ◽  
pp. 263-267 ◽  
Author(s):  
R. Shane Tubbs ◽  
Jason M. Rogers ◽  
Marios Loukas ◽  
Ayhan Cömert ◽  
Mohammadali M. Shoja ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Ulnar Artery ◽  
Medial Epicondyle ◽  
Palmar Arch ◽  
Medial Side ◽  
Fourth Digit ◽  
Palmar Cutaneous Branch ◽  
Cutaneous Branch ◽  
The Mean

Object The palmar cutaneous branch of the ulnar nerve (PCUN) has received little attention in the literature, and to the authors' knowledge, has received no attention in the neurosurgical literature. The present study was performed to help the surgeon minimize postoperative complications of nerve decompression at the wrist. Methods Forty cadaveric upper limbs underwent dissection of the ulnar nerve in the forearm, at the wrist, and in the palm. The PCUN was investigated and when identified, measurements were made and relationships documented between this cutaneous branch and the ulnar artery. The length and width of the PCUN were measured, as was the distance from the medial epicondyle of the humerus to the origin of the PCUN from the ulnar nerve. Results A PCUN was found on 90% of sides. The origin of the PCUN from the ulnar nerve was found to lay a mean of 14.3 cm distal to the medial epicondyle. The mean length and width of this branch were 13 and 0.08 cm, respectively. In the forearm, the PCUN traveled lateral to the ulnar artery on 75% of sides and on the medial side of this vessel on the remaining sides. The PCUN perforated the fascia of the anterior forearm just proximal to the distal wrist crease. In the palm, the PCUN traveled superficial to the superficial palmar arch on all but 5 sides, where it traveled deep to this vascular structure's distal extent. On 2 sides each, the PCUN communicated with the superficial and deep ulnar nerves. On 2 sides, the PCUN communicated with the palmar cutaneous branch of the median nerve. The majority of the terminal fibers of the PCUN were found on the ulnar side of a hypothetical line drawn longitudinally through the fourth digit and supplied an area roughly 3 × 3 cm over the proximal medial palm. Conclusions The authors hope that the present data may be useful to the surgeon during decompressive procedures at the wrist, such as carpal tunnel and the Guyon canal. Based on this study, skin incisions of the palm made longitudinally along a line through the middle of the fourth digit would minimize injury to the PCUN.

scholarly journals TOPOGRAFÍA INTRANEURAL DE LA RAMA PROFUNDA DEL NERVIO ULNAR EN EL ANTEBRAZO DISTAL: ESTUDIO CADAVÉRICO. Intraneural topography of the deep branch of the ulnar nerve in the distal forearm: cadaveric study.

2016 ◽  
Vol 8 (2) ◽  
pp. 73-79
Author(s):  
Joaquín García Pisón ◽  
Federico Fleitas ◽  
Bruno Garbarino ◽  
Claudia Millán ◽  
Emilia Cerchiari ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Neurovascular Bundle ◽  
Cadaveric Study ◽  
Distal Forearm ◽  
Pronator Quadratus ◽  
Deep Branch ◽  
Superficial Branch ◽  
Cutaneous Branch ◽  
Pisiform Bone

Objetivo: estudiar la topografía intraneural de la rama profunda del nervio ulnar (RPNU) en el antebrazo distal en vistas a su identificación mediante disección intraneural mínima durante la transferencia del nervio del pronador cuadrado (NPC) a la RPNU. Materiales y métodos: En 15 antebrazos cadavéricos se fijó el paquete vasculonervioso ulnar a los planos musculares profundos cada un centímetro tomando como referencia el hueso pisiforme. Se disecó en sentido proximal la RPNU bajo microscopio quirúrgico (Olympus OME, 4-20x) y se registró su posición intraneural en base a una división en cuadrantes. Se midió la distancia desde el origen de la rama cutánea dorsal (RCD) del nervio ulnar al pisiforme y se registró su relación intraneural con la RPNU. Resultados: La RPNU se individualizó hasta 69mm (41-94) proximal al hueso pisiforme, ubicándose en el cuadrante posteromedial del nervio ulnar en el 78% (67-87), el 93% (92-93) y el 100% de los casos entre los 0-2, 3-6 y 7-9 centímetros, respectivamente. La distancia pisiforme-RCD fue de 63mm (52-83). En 11 miembros la disección de la RPNU se extendió proximalmente al origen de la RCD, ubicándose siempre entre esta última y la rama superficial del nervio ulnar. Conclusiones: La topografía intraneural de la RPNU en el sitio óptimo para su sección en vistas a su anastomosis con el NPC es predecible en la mayoría de los casos, lo que confirma la viabilidad de su identificación precisa mediante disección intraneural mínima.  Objective: to assess the intraneural anatomy of the deep branch of the ulnar nerve (DBUN) in the distal forearm in reference to its identification by means of minimal intraneural dissection during pronator quadratus nerve to DBUN transfers. Materials and methods: In 15 cadaveric forearms the ulnar neurovascular bundle was identified and attached to the subjacent muscles every one centimeter. Pisiform bone was used as reference. Intraneural proximal dissection of the deep branch of the ulnar nerve was performed under magnification (Olympus OME, 4-20x) and its intraneural position was registered using a quadrants scheme. Distance from pisiform to the origin of the dorsal cutaneous branch of the ulnar nerve (DCB) was measured and its intraneural position relative to DBUN was identified. Results: The DBUN could be identified up to 69mm (41-94) proximal to the pisiform and occupied the posteromedial quadrant of the ulnar nerve in 78% (67-87), 93% (92-93) and 100% of the cases in the 0-2, 3-6 and 7-9cm ranges, respectively. Distance from pisiform to the origin of the DCB was 63mm (52-83). The DBUN could be identified proximal to the origin of the DCB in 11 forearms, being located between the latter and the superficial branch of the ulnar nerve in all this cases.  Conclusions: Intraneural topography of the DBUN in the most appropriate site for its identification during its anastomosis to the PQN is predictable in the majority of cases, which supports the viability of safe identification of the de DBUN by means of minimal intraneural dissection.

Susceptibility of the Superficial Sensory Branch of the Radial Nerve to Form Painful Neuromas

1984 ◽  
Vol 9 (1) ◽  
pp. 42-45 ◽  
Author(s):  
A. LEE DELLON ◽  
SUSAN E. MACKINNON
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Radial Nerve ◽  
Palmar Cutaneous Branch ◽  
Cutaneous Branch ◽  
Distal Fixation ◽  
Extensor Carpi Radialis

The superficial sensory branch of the radial nerve appears prone to develop painful neuromas out of proportion to its likelihood for injury. Based on cadaver dissections and intraoperative observations, an anatomical mechanism for this “predisposition” is suggested. Exit of this nerve beneath dense fascia and the tendons of brachioradialis and extensor carpi radialis longus provide a proximal tethering against which tension develops as the distal fixation point (neuroma) is pulled through the long excursion of wrist are of motion. This long excursion and proximal tethering are not present anatomically for the dorsal cutaneous branch of the ulnar nerve nor the palmar cutaneous branch of the median nerve.

Combined ulnar nerve palsy in Guyon's canal and distal median nerve irritation following excessive canoeing

2006 ◽  
Vol 37 (01) ◽  
Author(s):  
F Paul ◽  
F Paul ◽  
FJ Dieste ◽  
T Ratzlaff ◽  
HP Vogel ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Nerve Palsy ◽  
Guyon’S Canal ◽  
Ulnar Nerve Palsy ◽  
Guyon's Canal

A Schwannoma Originating from Median Nerve at Proximal Forearm Caused Ulnar Nerve Symptom by Compression

2014 ◽  
Vol 23 (2) ◽  
pp. 86-88
Author(s):  
Jeong Hyun Yoo ◽  
Joon Yub Kim ◽  
Hyoung Soo Kim ◽  
Joo Hak Kim ◽  
Ki Hyuk Sung ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Proximal Forearm
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