Anatomical variations of the palmar cutaneous branch of the median nerve

ABSTRACT

Twenty cadaveric upper limbs were studied to identify the course of the palmar cutaneous branch of the median nerve [PCBMN] and its relation to the commonly used surgical landmarks of the palm of the hand. Dissection was begun in the forearm by exposing the median nerve, then the incision was extended distally into the palm along the thenar crease. The PCBMN was then exposed at the radial side of the median nerve and traced distally into the palm. The relationship of the PCBMN to the overlying soft tissue landmarks was then measured at the level of the distal wrist crease. The palmar cutaneous nerve of the median nerve was found closely underlie the thenar skin crease [range of 6 mm ulnar to 6 mm radial to the thenar skin crease]. The nerve traveled an average of 5 mm radial to the interthenar depression [range, 0- 12 mm redial]. So, these anatomical variations should be recommended for surgical approaches to the carpal tunnel release