scholarly journals A study of relation of recurrent muscular branch of median nerve to flexor retinaculum in cadavers

2020 ◽  
Vol 13 (1) ◽  
pp. 24-25
Author(s):  
Pampi Ranjan ◽  
◽  
P S Bhuiyan ◽  
Keyword(s):  
Median Nerve ◽  
Flexor Retinaculum ◽  
Muscular Branch

scholarly journals Supraretinacular endoscopic carpal tunnel release: A safe alternative method for treatment of carpal tunnel syndrome

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199340
Author(s):  
Kotaro Sato ◽  
Kenya Murakami ◽  
Yoshikuni Mimata ◽  
Gaku Takahashi ◽  
Minoru Doita
Keyword(s):  
Learning Curve ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Open Surgery ◽  
Carpal Tunnel Release ◽  
Safe Alternative ◽  
Endoscopic Carpal Tunnel Release ◽  
Flexor Retinaculum ◽  
Carpal Tunnel Surgery ◽  
Conversion Rates

Purpose: Supraretinacular endoscopic carpal tunnel release (SRECTR) is a technique in which an endoscope is inserted superficial to the flexor retinaculum through a subcutaneous tunnel. The benefits of this method include a clear view for the surgeon and absence of median nerve compression. Surgeons can operate with a familiar view of the flexor retinaculum and median nerve downward, similar to open surgery. This study aimed to investigate the learning curve for SRECTR, an alternate method for carpal tunnel release, and evaluate its complications and the functional outcomes using a disposable commercial kit. Methods: We examined the open conversion rates and complications associated with SRECTR in 200 consecutive patients performed by two surgeons. We compared the operative time operated by a single surgeon. We evaluated outcomes in 191 patients according to Kelly’s grading system. Patients’ mean follow-up period was 12.7 months. Results: Nine patients required conversion to open surgery. There were no injuries to the nerves and tendons and no hematoma or incomplete dissection of the flexor retinaculum. The operative times varied between 11 and 34 minutes. We obtained the following results based on Kelly’s grading of outcomes: excellent in 116, good in 59, fair in 13, and poor in 3 patients. Conclusions: We found no patients with neurapraxia, major nerve injury, flexor tendon injury, superficial palmar arch injury, and hematoma. Although there was a learning curve associated with SRECTR, we performed 200 consecutive cases without neurovascular complications. This method may be a safe alternative to minimally invasive carpal tunnel surgery.

scholarly journals Aberrant Positioning of the Ulnar Nerve Found During Carpal Tunnel Release: A Case Report

2019 ◽  
Author(s):  
David R. Veltre ◽  
Kelvin Naito ◽  
Xinning Li ◽  
Andrew B. Stein
Keyword(s):  
Case Report ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Distal Forearm ◽  
Anatomic Variations ◽  
Transverse Carpal Ligament ◽  
Iatrogenic Injuries ◽  
Flexor Retinaculum

Introduction: Aberrant positioning of the ulnar nerve volar to the transverse carpal ligament is a rare anatomic variation.Case Presentation: We present the case of a 55-year-old female with unique ulnar nerve anatomy that was discovered introperatively during carpal tunnel release.  The ulnar nerve was running directly adjacent to the median nerve in the distal forearm and as the median nerve traversed dorsal to the transverse carpal ligament (flexor retinaculum) to enter the carpal tunnel the ulnar nerve continued directly volar to this structure before angling towards Guyon’s Canal.  The unique ulnar nerve anatomy was successfully identified, carefully dissected and managed with a successful patient outcome.Conclusion: Variations of the anatomy at the level of the carpal tunnel are rare but do exist.  Awareness of these anatomic variations and adequate visualization of the ulnar nerve along with the surrounding structures is crucial to avoid iatrogenic injuries during carpal tunnel release. 

A New Technique for Endoscopic Carpal Tunnel Decompression

1995 ◽  
Vol 20 (4) ◽  
pp. 465-469 ◽  
Author(s):  
T. M. TSAI ◽  
T. TSURUTA ◽  
S. A. SYED ◽  
H. KIMURA
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Glass Tube ◽  
New Technique ◽  
Motor Branch ◽  
Flexor Retinaculum ◽  
Fresh Cadaver ◽  
Custom Made ◽  
Portal Technique

A new one-portal technique for endoscopic carpal tunnel release (ECTR) is introduced with its clinical results. The incision is made at the palmar aspect of file hand. A custom-made glass tube with a groove is inserted, and under endoscope observation, a meniscus knife is pushed forward along the groove to release the flexor retinaculum. This new technique has been studied in ten fresh cadaver hands and used in 123 patients' hands. Results of the cadaver study showed that the flexor retinaculum was released completely in all ten hands. No injuries to tendons, nerves, or arteries were noted. In one case the cotton tip was lost from the stick. All clinical releases were performed uneventfully except for three cases of neuropraxia of the digital nerve of the radial side of the ring finger, one laceration of the motor branch of the median nerve, one mild infection, one loss of cotton tip from the cotton swab stick, and one case of chipping of the glass tube. The case with the laceration of the motor branch of the median nerve occurred early in the series and required the conventional open incision to repair the nerve. The cases with loss of cotton from the stick and chipping of the tube also required a conventional incision to remove the cotton and glass chip. Advantages of this one-portal technique with the glass tube include less scar tenderness than with two-portal techniques, decreased risk of injury to the superficial palmar arch and ulnar nerve because of the distal approach, a view of pathology in the carpal tunnel through the glass tube, and confirmation of release of the flexor retinaculum.

Transverse Sliding of the Median Nerve Beneath the Flexor Retinaculum

1992 ◽  
Vol 17 (2) ◽  
pp. 213-216 ◽  
Author(s):  
K. NAKAMICHI ◽  
S. TACHIBANA
Keyword(s):  
Median Nerve ◽  
Flexor Tendons ◽  
Flexor Retinaculum ◽  
Physiological Phenomenon

Transverse sliding of the median nerve beneath the flexor retinaculum during active-resistant flexion of the fingers was sonographically demonstrated. Although it is a physiological phenomenon, it may cause mechanical nerve deformation in addition to longitudinal sliding when the nerve is subject to compression against the flexor retinaculum by tensed overlying flexor tendons.

scholarly journals Course Pattern of the Muscular Branch of the Median Nerve in Sri Lankans Hand

2009 ◽  
Vol 27 (4) ◽  
Author(s):  
Kithsiri J Senanayake ◽  
Sujatha Salgado ◽  
Ranil Fernando
Keyword(s):  
Median Nerve ◽  
Muscular Branch

scholarly journals Study of muscular branch of median nerve to the pronator teres

2013 ◽  
Vol 2 (2) ◽  
pp. 67
Author(s):  
MK Bindurani ◽  
HM Lokesh ◽  
BN Nanjundappa
Keyword(s):  
Median Nerve ◽  
Pronator Teres ◽  
Muscular Branch

scholarly journals VARIATIONS IN DISTRIBUTION OF MEDIAN NERVE IN THE HAND AND ITS RELATIONS IN FLEXOR RETINACULUM

2017 ◽  
Vol 4 (26) ◽  
pp. 1535-1541
Author(s):  
Vijayamma Kunnath Narayanan ◽  
Ushavathy Padmanabhan ◽  
Jude Jose Thomson ◽  
Anjana Jayakumaran Nair
Keyword(s):  
Median Nerve ◽  
Flexor Retinaculum

scholarly journals Ultrasound as a diagnostic tool in the investigation of patients with carpal tunnel syndrome

2018 ◽  
Vol 28 (2) ◽  
Author(s):  
Leila Kanafi Vahed ◽  
Afshin Arianpur ◽  
Mohammad Gharedaghi ◽  
Hosein Rezaei
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Clinical Symptoms ◽  
Cost Effective ◽  
Time Saving ◽  
Cross Sectional ◽  
Clinical Criteria ◽  
Flexor Retinaculum ◽  
Tunnel Syndrome

Carpal tunnel syndrome (CTS) is reveled to be the most common peripheral nerve entrapment syndrome, estimating for 90% of all compressive. The diagnosis of CTS is based on the use of clinical criteria and imaging technique tests such as ultrasonography (US) and magnetic resonance imaging (MRI). US is a time-saving method in the diagnosis of CTS, which induces less discomfort to the patient and may be a more cost-effective approach to confirm clinical suspicion of this syndrome .The current study was aimed to evaluate the value of US and physical examinations in the diagnosis of CTS. This cross-sectional and cross-sectional prospective case study was conducted to evaluate the usefulness of wrist ultrasonography in diagnosing CTS. Twenty one patients (21 wrists) were invited to participate in the study along with an age- and sex-matched group of participant controls. Physical examination included Phalen, Tinel, Durkan, Tourniquet test. Anteroposterior and mediolateral dimension of carpal tunnel, and the median nerve area at the tunnel were also measured. All the patients underwent the open surgical release of the flexor retinaculum. There was a significant statistical relationship (p=0.05) between anteroposterior diameter of the carpal tunnel and clinical and electro physiologic nerve involvement. Furthermore, some qualitative findings was achieved such as median nerve splitting, hypo echogenicity of the involved nerve, thickening of flexor retinaculum and disappearance of median nerve areas (especially mediolateral direction). In conclusion, ultrasonographic examination of the wrists in the patients with suspected clinical symptoms can improve the diagnostic ability of CTS, especially by improving technology and experience. US can be applied for the median nerve area (MNA) measurement as a first line technique in patients with CTS.

Triggering of the Finger at the Flexor Retinaculum

HAND ◽  
1982 ◽  
Vol os-14 (1) ◽  
pp. 53-55 ◽  
Author(s):  
Q. M. Iqbal
Keyword(s):  
Median Nerve ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Unusual Case ◽  
Trigger Finger ◽  
Flexor Retinaculum

An unusual case of trigger finger associated with paraesthesia of the hand is described. The site of triggering was at the flexor retinaculum consequent upon a tumour of the profundus tendon. Nerve conduction study of the median nerve revealed a co-existing incipient median neuritis.

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