Palmar cutaneous branch of median nerve: An anatomical study

Abstract

The purpose of this study was to determine the origin, frequency and anatomical variations of the palmar cutaneous branch of the median nerve (PCBMN) and its clinical implications in surgical procedures such as decompression of the carpal tunnel and volar approach to the wrist. Dissection of 30 forearms from 18 adult male specimens (9 bilateral, 7 right limbs and 5 left limbs) were performed using 2.5X magnification loupe in order to better understand the PCBMN. Origin, number, length, positioning, anatomical relations and variations were recorded and analyzed. The PCBMN was identified in all dissected forearms, being the most distal branch of the median nerve in all forearms. The average origin was 4.8 cm (ranging 3.8 to 6.5 cm) proximal to the wrist flexion crease. Anatomical variations of the PCBMN are not rare and could endanger the nerve during surgical approach for the volar wrist and proximal palm. We did not find the PCBMN positioned ulnar to the fourth metacarpal axis as well as radial to the flexor carpi radialis tendon.