Surgical Anatomical Application Of Median Nerve Variations And Branching Pattern At Carpal Tunnel

Abstract

Background and objectives: Median Nerve is called labourer’s nerve as it supplies large flexor muscles of  forearm and five intrinsic muscles of hand which help in movement of the thumb. Comprehensive knowledge pertaining to its variations is extremely important in clinical and surgical procedures so as to avoid injury to it. The precise knowledge of level of origin of muscular branches of median nerve is essential in free muscular transfers to restore the mobility of fingers after trauma and to understand the various presentations of distribution of median nerve. The anatomical knowledge and variations of recurrent motor branch of median nerve is important to prevent the complications during the carpal tunnel decompression. The objectives of the study are: (1) To know about the variations and branching pattern of median nerve in carpal tunnel (2) To learn the mode of origin of recurrent motor branch and its relation to flexor retinaculum. Methodology: The study was done on 51 upper limb human cadaver specimens which were  collected from dissection room from Department of Anatomy, SNMIH and help of Other Medical College and these specimens include both adult and viable foetal cadavers, over a period of Two years. The specimens obtained were fixed in 10% formalin and were finely dissected. Conclusion: In the present study an attempt is made to know the possible variations of median nerve branching pattern and termination in carpal tunnel so as to provide additional information which may help to decrease the risk of diagnostic and operative complications. The present study concludes that the different types of variations in cadavers which have been studied would be of immense help for successful clinical approaches. Keywords: Median Nerve; Carpal Tunnel; Flexor Retinaculum; Carpal Tunnel Syndrome