» Articles » PMID: 33144842

INNERVATION OF THE MEDIAN NERVE MOTOR BRANCHES IN THE FOREARM AND ITS CLINICAL SIGNIFICANCE

Overview
Journal Acta Ortop Bras
Specialty Orthopedics
Date 2020 Nov 4
PMID 33144842
Citations 1
Authors
Affiliations
Soon will be listed here.
Abstract

Objective: To analyse the anatomical variations of the median nerve motor branches in the elbow region.

Methods: Twenty upper limbs of 10 adult male cadavers were prepared by intra-arterial injection of a solution of 10% glycerol and formaldehyde. All cadavers belonged to the institution anatomy laboratory.

Results: We found a great variability within the distribution of median nerve branches leading to forearm muscles. Only three limbs (14%) presented the normal standard of innervation described in anatomy treatises. The pronator teres muscle (PTM), flexor carpi radialis (FCR), palmaris longus (PL), and the flexor digitorum superficialis (FDS) received exclusive innervation from the median nerve in all forearms. The anterior interosseous nerve (AIN) also originated from the median nerve in all dissected limbs.

Conclusion: A thorough understanding of the anatomy of the median nerve branches is important for performing surgeries such as: approach to the proximal third of the forearm, alleviation of pronator teres and anterior interosseous nerve compression syndromes, and distal nerve transfers. It also enables a better understanding the recovery of muscle function after a nerve injury.

Citing Articles

Pronator teres nerve branch transfer to the extensor carpi radialis brevis nerve branch for wrist extension reconstruction in proximal radial nerve injury following humeral shaft fractures.

Tian J, Leng M, Wang K, Huang Q BMC Musculoskelet Disord. 2022; 23(1):980.

PMID: 36371190 PMC: 9652830. DOI: 10.1186/s12891-022-05950-1.

References
1.
Canovas F, Mouilleron P, Bonnel F . Biometry of the muscular branches of the median nerve to the forearm. Clin Anat. 1998; 11(4):239-45. DOI: 10.1002/(SICI)1098-2353(1998)11:4<239::AID-CA3>3.0.CO;2-M. View

2.
Segal R . Neuromuscular compartments in the human biceps brachii muscle. Neurosci Lett. 1992; 140(1):98-102. DOI: 10.1016/0304-3940(92)90691-y. View

3.
Fuss F, Wurzl G . Median nerve entrapment. Pronator teres syndrome. Surgical anatomy and correlation with symptom patterns. Surg Radiol Anat. 1990; 12(4):267-71. DOI: 10.1007/BF01623702. View

4.
Tung T, Mackinnon S . Flexor digitorum superficialis nerve transfer to restore pronation: two case reports and anatomic study. J Hand Surg Am. 2001; 26(6):1065-72. DOI: 10.1053/jhsu.2001.28427. View

5.
El-Din Safwat M, Abdel-Meguid E . Distribution of terminal nerve entry points to the flexor and extensor groups of forearm muscles: an anatomical study. Folia Morphol (Warsz). 2007; 66(2):83-93. View