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Published in:

01-08-2011 | Original Article

Prevalence of bifid median nerve at wrist assessed through ultrasound

Authors: Giuseppe Granata, Pietro Caliandro, Costanza Pazzaglia, Ileana Minciotti, Giuseppina Russo, Carlo Martinoli, Luca Padua

Published in: Neurological Sciences | Issue 4/2011

Abstract

We performed a prospective study to evaluate the prevalence of bifid median nerve (BMN) and if it has a higher prevalence in carpal tunnel syndrome (CTS) patients than symptom-free subjects. We evaluated by ultrasound (US) 162 median nerves at wrist of 89 consecutive patients with symptoms suggestive of CTS and 104 of 52 consecutive symptom-free subjects. Neurophysiological evaluation confirmed CTS diagnosis. All patients underwent ultrasonographic evaluation of median nerve in the elbow–palm segment through high-frequency probe; BMN was arbitrarily classified as “complete” and “incomplete” on the basis of US results. BMN was observed in 16/104 wrists (15.4%) in control group and in 30/162 (18.5%) wrists in CTS group. Our study showed that BMN is frequent, not always bilateral, more often is “incomplete” and it has similar prevalence in CTS and control group. These findings suggest that BMN is not a risk factor of developing CTS.

Chabaud B, Flocard F, Dasse Y, Ribot C, Bady B, Sindou M (1993) Surgical applications of anatomical variations of the median nerve at the wrist. Neurochirurgie 39(2):92–100PubMed

Berry MG, Vijh V, Percival NJ (2003) Bifid median nerve : anatomical variant at the carpal tunnel. Scand J Plast Reconstr Surg Hand Surg 37(1):58–60PubMed

Kele H, Verheggen R, Reimers CD (2002) Carpal tunnel syndrome caused by thrombosis of the median artery: the importance of high-resolution ultrasonography for diagnosis Case report. J Neurosurg 97(2):471–473PubMedCrossRef

Lanz U (1977) Anatomical variations of the median nerve in the carpal tunnel. J Hand Surg Am 2(1):44–53PubMed

Lindley SG, Kleinert JM (2003) Prevalence of anatomic variations encountered in elective carpal tunnel release. J Hand Surg Am 28(5):849–855PubMedCrossRef

Tountas CP, Macdonald CJ, Meyerhoff JD, Bihrle DM (1983) Carpal tunnel syndrome. A review of 507 patients. Minn Med 66(8):479–482PubMed

Schmelzer RE, Della Rocca GJ, Caplin DA (2006) Endoscopic carpal tunnel release: a review of 753 cases in 486 patients. Plast Reconstr Surg 117(1):177–185PubMedCrossRef

Iannicelli E, Almberger M, Chianta GA, Salvini V, Drudi FM, Rossi G et al (2001) Bifid median nerve in the carpal tunnel: integrated imaging. Radiol Med 101(6):456–458PubMed

Iannicelli E, Chianta GA, Salvini V, Almberger M, Monacelli G, Passariello R (2000) Evaluation of bifid median nerve with sonography and MR imaging. J Ultrasound Med 19(7):481–485PubMed

10.

Bayrak IK, Bayrak AO, Kale M, Turker H, Diren BJ (2008) BMN in patients with carpal tunnel syndrome. Ultrasound Med 27(8):1129–1136

11.

American Academy of Neurology, American Association of Electrodiagnostic Medicine, American Academy of Physical Medicine and Rehabilitation (1993) Practice parameter for carpal tunnel syndrome (summary statement). Neurology 43(11):2406–2409

12.

Padua L, Giannini F, Girlanda P, Insola A, Luchetti R, Lo Monaco M et al (1999) Usefulness of segmental and comparative tests in the electrodiagnosis of carpal tunnel syndrome: the Italian multicenter study Italian CTS Study Group. Ital J Neurol Sci 20(5):315–320PubMedCrossRef

13.

Cobb TK, Amadio PC (1996) Reoperation for carpal tunnel syndrome. Hand Clin 12(2):313–323PubMed

14.

Jones DP (2006) Bilateral palmaris profundus in association with bifid median nerve as a cause of failed carpal tunnel release. J Hand Surg Am 31(5):741–743PubMedCrossRef

15.

Sánchez Lorenzo J, Cañada M, Díaz L, Sarasúa G (1996) Compression of the median nerve by an anomalous palmaris longus tendon: a case report. J Hand Surg Am 21(5):858–860PubMedCrossRef

16.

Dutly-Guinand M, Müller M, Bleuler P, Steiger R (2009) Carpal tunnel syndrome from a thrombosed median artery–four case reports and review of the literature. Handchir Mikrochir Plast Chir. 2009 Jun 41(3):179–182 (Epub 2009 Mar 25)

Title: Prevalence of bifid median nerve at wrist assessed through ultrasound
Authors: Giuseppe Granata
Pietro Caliandro
Costanza Pazzaglia
Ileana Minciotti
Giuseppina Russo
Carlo Martinoli
Luca Padua
Publication date: 01-08-2011
Publisher: Springer Milan
Published in: Neurological Sciences / Issue 4/2011
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-011-0582-8

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Prevalence of bifid median nerve at wrist assessed through ultrasound

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