Advertisement
Scientific article| Volume 35, ISSUE 1, P27-29, January 2010

Anomaly of Flexor Digitorum Superficialis Penetrating Through the Median Nerve: Case Report

      The median nerve displays frequent anatomic variation. Here, we report an unusual anatomic variation consisting of a penetrated median nerve and the tendon of the flexor digitorum superficialis to the index finger passing through it approximately 4 cm proximal to the wrist crease.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Figueiredo U.M.
        • Hooper G.
        Abnormal course of the median nerve associated with an anomalous belly of flexor digitorum superficialis.
        Hand. 1980; 12: 273-274
        • Lanz U.
        Anatomical variations of the median nerve in the carpal tunnel.
        J Hand Surg. 1977; 2: 44-53
        • Krol A.
        • Palczak A.
        • Jedrzejewski K.S.
        Split median nerve: a report of two cases.
        Folia Morphol (Warsz). 2005; 64: 341-344
        • Chabaud B.
        • Flocard F.
        • Dasse Y.
        • Ribot C.
        • Bady B.
        • Sindou M.
        Surgical applications of the anatomical variations of the median nerve at the wrist.
        Neurochirurgie. 1993; 39: 92-100
        • Jeon I.H.
        • Kim P.T.
        • Park I.H.
        • Park B.C.
        • Ihn J.C.
        High bifurcation of median nerve at the wrist causing common digital nerve injury in endoscopic carpal tunnel release.
        J Hand Surg. 2002; 27B: 580-582
        • Cavallo A.V.
        • Slattery P.G.
        • Barton R.J.
        Endoscopic carpal tunnel release and congenital anomalies of the median nerve.
        Hand Surg. 2003; 8: 265-270
        • Lanz U.
        Anatomical variations of the median nerve in the carpal tunnel.
        J Hand Surg. 1977; 2: 44-53
        • Stancic M.F.
        • Eskinja N.
        • Stosic A.
        Anatomical variations of the median nerve in the carpal tunnel.
        Int Orthop. 1995; 19: 30-34
        • Bayrak I.K.
        • Bayrak A.O.
        • Kale M.
        • Turker H.
        • Diren B.
        Bifid median nerve in patients with carpal tunnel syndrome.
        J Ultrasound Med. 2008; 27: 1129-1136
        • Berry M.G.
        • Vijh V.
        • Percival N.J.
        Bifid median nerve: anatomical variant at the carpal tunnel.
        Scand J Plast Reconstr Surg Hand Surg. 2003; 37: 58-60
        • Fernandez-Garcia S.
        • Pi-Folguera J.
        • Estallo-Matino F.
        Bifid median nerve compression due to a musculotendinous anomaly of FDS to the middle finger.
        J Hand Surg. 1994; 19B: 616-617
        • Schlafy B.
        • Lister G.
        Median nerve compression secondary to bifid reversed palmaris longus.
        J Hand Surg. 1987; 12A: 371-373
        • Jones D.P.
        Bilateral palmaris profundus in association with bifid median nerve as a cause of failed carpal tunnel release.
        J Hand Surg. 2006; 31A: 741-743
        • Amadio P.C.
        Bifid median nerve with a double compartment within the transverse carpal tunnel.
        J Hand Surg. 1987; 12A: 366-368
        • Kornberg M.
        • Aulicino P.L.
        • DuPuy T.E.
        Bifid median nerve with three thenar branches: case report.
        J Hand Surg. 1983; 8: 583-584
        • Chabaud B.
        • Flocard F.
        • Dasse Y.
        • Ribot C.
        • Bady B.
        • Sindou M.
        Surgical applications of the anatomical variations of the median nerve at the wrist.
        Neurochirurgie. 1993; 39: 92-100
        • Vázquez M.T.
        • Murillo J.
        • Maranillo E.
        • Parkin I.G.
        • Sanudo J.
        Femoral nerve entrapment: a new insight.
        C Surg Radiol Anat. 2003; 25: 462-464
        • Vázquez T.
        • Rodríguez-Niedenführ M.
        • Parkin I.
        • Sañudo J.R.
        A rare case of a four-headed biceps brachii muscle with a double piercing by the musculocutaneous nerve.
        Surg Radiol Anat. 2003; 25: 462-464
        • Tountas C.P.
        • Bihrle B.S.
        • MacDonald C.J.
        • Bergman R.A.
        Variations of the median nerve in the carpal canal.
        J Hand Surg. 1987; 12A: 708-712
        • Graham W.P.
        Variations of the motor branch of the median nerve at the wrist.
        Plast Reconstr Surg. 1973; 51: 90-92
        • Mannerfelt L.
        • Hybbinette C.-H.
        Important anomaly of the thenar motor branch of the median nerve.
        Bull Hosp Joint Dis. 1972; 33: 15-21
        • Castorina S.
        • Branciforti B.
        • Spata G.
        • Giuffrida S.
        • Catana G.
        High division of the median nerve in the carpal tunnel: anatomical observations.
        Ital J Anat Embryol. 2001; 106: 119-126
        • Beris A.E.
        • Lykissas M.G.
        • Kontogeorgakos V.A.
        • Vekris M.D.
        • Korompilias A.V.
        Anatomic variations of the median nerve in carpal tunnel release.
        Clin Anat. 2008; 21: 514-518
        • Kessler I.
        Unusual distribution of the median nerve.
        Clin Orthop Relat Res. 1969; 67: 124-126
        • Szabo R.M.
        • Pettey J.
        Bilateral median nerve bifurcation with an accessory compartment within the carpal tunnel.
        J Hand Surg. 1994; 19B: 22-23
        • Bayrak I.K.
        • Bayrak A.O.
        • Kale M.
        • Turker H.
        • Diren B.
        Bifid median nerve in patients with carpal tunnel syndrome.
        J Ultrasound Med. 2008; 27: 1129-1136
        • Jeon I.H.
        • Kim P.T.
        • Park I.H.
        • Park B.C.
        High bifurcation of median nerve at the wrist causing common digital nerve injury in endoscopic carpal tunnel release.
        J Hand Surg. 2002; 27B: 580-582
        • Rodner C.M.
        • Akelman E.
        • Brody J.M.
        • Weiss A.P.
        Anomalous median nerve position dorsal to the flexor tendons in a patient with spastic hemiplegia and wrist pain: case report.
        J Hand Surg. 2007; 32A: 867-870
        • Stellbrink G.
        Compression of the palmar branch of the median nerve by atypical palmaris longus muscle.
        Handchirurgie. 1972; 4: 155-157
        • Mauger A.
        • Kieny M.
        • Hedayat I.
        • Goetinck P.F.
        Tissue interactions in the organization and maintenance of the muscle pattern in the chick limb.
        J Embryol Exp Morphol. 1983; 76: 199-215
        • Moore K.L.
        • Persaud T.V.N.
        The developing human: clinically oriented embryology.
        in: 5th ed. WB Saunders, Philadelphia1993: 416-417