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Original article
Published online: 2020-05-04
Submitted: 2020-03-10
Accepted: 2020-03-30
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The anatomical landmarks effective in the localization of the median nerve during orthopedic procedures

E. Mizia, P. A. Pekala, B. Skinningsrud, B. Rutowicz, P. Piekos, A. Baginski, K. A. Tomaszewski
DOI: 10.5603/FM.a2020.0049
·
Pubmed: 32394419

open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2020-05-04
Submitted: 2020-03-10
Accepted: 2020-03-30

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 7.87mm (95%CI: 7.37-8.37) and the distance from flexor carpi ulnaris tendon to MN (FCU-MN) was 19.09mm (95%CI: 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 7.87mm (95%CI: 7.37-8.37) and the distance from flexor carpi ulnaris tendon to MN (FCU-MN) was 19.09mm (95%CI: 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.

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Keywords

median nerve; flexor carpi radialis; flexor carpi ulnaris; iatrogenic injury; carpal tunnel release, anatomical landmarks

About this article
Title

The anatomical landmarks effective in the localization of the median nerve during orthopedic procedures

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Original article

Published online

2020-05-04

DOI

10.5603/FM.a2020.0049

Pubmed

32394419

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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