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The anatomical landmarks effective in the localisation of the median nerve during orthopaedic procedures
Affiliations- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
- International Evidence-Based Anatomy Working Group, Krakow, Poland
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
open access
Abstract
Background: The aim of this study was to create a safe zone for surgeons who perform procedures in the wrist to avoid iatrogenic damage to the median nerve (MN) by identifying anatomical landmarks using ultrasound (USG).
Materials and methods: We measured the distances between the MN and two easily identifiable anatomical landmarks at the level of the proximal border of carpal ligament using USG.
Results: A total of 57 volunteers (n = 114 upper limbs) were included in this study. Our main findings revealed that the distance from the flexor carpi radialis tendon to MN (FCR-MN) was 7.87 mm (95% confidence interval 7.37–8.37) and the distance from flexor carpi ulnaris tendon to MN (FCU-MN) was 19.09 mm (95% confidence interval 18.51–19.67).
Conclusions: The tendons of FCR and FCU are easily identifiable landmarks that can be distinguished using simple palpation. Based on our USG findings, the area around FCR should be carefully navigated to avoid iatrogenic injury to the MN during surgical procedures around the carpal tunnel.
Abstract
Background: The aim of this study was to create a safe zone for surgeons who perform procedures in the wrist to avoid iatrogenic damage to the median nerve (MN) by identifying anatomical landmarks using ultrasound (USG).
Materials and methods: We measured the distances between the MN and two easily identifiable anatomical landmarks at the level of the proximal border of carpal ligament using USG.
Results: A total of 57 volunteers (n = 114 upper limbs) were included in this study. Our main findings revealed that the distance from the flexor carpi radialis tendon to MN (FCR-MN) was 7.87 mm (95% confidence interval 7.37–8.37) and the distance from flexor carpi ulnaris tendon to MN (FCU-MN) was 19.09 mm (95% confidence interval 18.51–19.67).
Conclusions: The tendons of FCR and FCU are easily identifiable landmarks that can be distinguished using simple palpation. Based on our USG findings, the area around FCR should be carefully navigated to avoid iatrogenic injury to the MN during surgical procedures around the carpal tunnel.
Keywords
median nerve, flexor carpi radialis, flexor carpi ulnaris, iatrogenic injury, carpal tunnel release, anatomical landmarks
About this articleTitle
The anatomical landmarks effective in the localisation of the median nerve during orthopaedic procedures
Journal
Issue
Article type
Original article
Pages
248-254
Published online
2020-05-04
Page views
1354
Article views/downloads
1318
DOI
Pubmed
Bibliographic record
Folia Morphol 2021;80(2):248-254.
Keywords
median nerve
flexor carpi radialis
flexor carpi ulnaris
iatrogenic injury
carpal tunnel release
anatomical landmarks
Authors
E. Mizia
P. A. Pekala
B. Skinningsrud
B. Rutowicz
P. Piekos
A. Baginski
K. A. Tomaszewski
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