open access

Vol 73, No 4 (2014)
ORIGINAL ARTICLES
Published online: 2014-11-28
Submitted: 2013-12-10
Accepted: 2014-01-22
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Determination of the median nerve safe-zone in the carpal tunnel using the distal forearm bony prominences

N. O. Ajayi, N. Naidoo, L. Lazarus, K. S. Satyapal
DOI: 10.5603/FM.2014.0062
·
Folia Morphol 2014;73(4):409-413.

open access

Vol 73, No 4 (2014)
ORIGINAL ARTICLES
Published online: 2014-11-28
Submitted: 2013-12-10
Accepted: 2014-01-22

Abstract

Background: The compression of the median nerve (MN) in the carpal tunnel (CT) is one of the most common aetiologies of entrapment neuropathy syndromes in clinical practice. The aim of this study was to investigate the relationship of the palpable bony prominences of the distal forearm (radial styloid process [RSP] and ulnar styloid process [USP]) with MN in the CT, in order to determine a safe-zone of the MN during carpal tunnel procedures.

Materials and methods: This study involved the bilateral dissection of the CT region of 30 adult cadaveric specimens (n = 60).

Results: The mean distance between the RSP and USP was 49.34 mm. The mean distance of the MN from the RSP and the USP were 22.44 mm and 26.66 mm, respectively. The mean diameter of the MN within the CT deep to the flexor retinaculum was 5.93 mm. In addition, the MN was located postero-lateral and postero-medial to palmaris longus tendon (PLT) in 78.33% and 21.67% of specimens, respectively.

Conclusions: This study found that the MN was located less than 60% of the RSP-USP distance from the RSP. Furthermore, the MN was mostly located postero-lateral to the PLT. Therefore, injection or surgical incision made at/medial to a point 60% of the RSP-USP distance from the RSP will be outside the safe-zone of the MN. The knowledge of this surface anatomical relationship of the MN may be useful during decompression for CT syndrome.

Abstract

Background: The compression of the median nerve (MN) in the carpal tunnel (CT) is one of the most common aetiologies of entrapment neuropathy syndromes in clinical practice. The aim of this study was to investigate the relationship of the palpable bony prominences of the distal forearm (radial styloid process [RSP] and ulnar styloid process [USP]) with MN in the CT, in order to determine a safe-zone of the MN during carpal tunnel procedures.

Materials and methods: This study involved the bilateral dissection of the CT region of 30 adult cadaveric specimens (n = 60).

Results: The mean distance between the RSP and USP was 49.34 mm. The mean distance of the MN from the RSP and the USP were 22.44 mm and 26.66 mm, respectively. The mean diameter of the MN within the CT deep to the flexor retinaculum was 5.93 mm. In addition, the MN was located postero-lateral and postero-medial to palmaris longus tendon (PLT) in 78.33% and 21.67% of specimens, respectively.

Conclusions: This study found that the MN was located less than 60% of the RSP-USP distance from the RSP. Furthermore, the MN was mostly located postero-lateral to the PLT. Therefore, injection or surgical incision made at/medial to a point 60% of the RSP-USP distance from the RSP will be outside the safe-zone of the MN. The knowledge of this surface anatomical relationship of the MN may be useful during decompression for CT syndrome.

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Keywords

median nerve, ulna styloid process, radial styloid process, carpal tunnel, carpal tunnel syndrome

About this article
Title

Determination of the median nerve safe-zone in the carpal tunnel using the distal forearm bony prominences

Journal

Folia Morphologica

Issue

Vol 73, No 4 (2014)

Pages

409-413

Published online

2014-11-28

DOI

10.5603/FM.2014.0062

Bibliographic record

Folia Morphol 2014;73(4):409-413.

Keywords

median nerve
ulna styloid process
radial styloid process
carpal tunnel
carpal tunnel syndrome

Authors

N. O. Ajayi
N. Naidoo
L. Lazarus
K. S. Satyapal

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