Summary
The median nerve was explored in 100 hands and the variations classified by the Lanz system. Only 47.7% of hands showed the standard anatomy described in textbooks. Rare variations were also found. Knowledge of the variable anatomy of the nerve could help to avoid incomplete decompression at operations for carpal tunnel entrapment and injury to the thenar branch of the nerve. The possibility of double thenar innervation must be considered in preoperative evaluation and in the follow up of median nerve injuries.
Résumé
L'objet de ce travail est d'évaluer la fréquence des variations du nerf médian dans le canal carpien. Le nerf médian a été étudié sur 100 mains et les variations ont été classées selon le système de Lanz. Quarante-sept, sept % des mains seulement étaient conformes à la description classique (anatomie de Gray). Dans le groupe 2 les auteurs ont observé une variation rare, décrite en 1904 par Chevrier. La connaissance des variations anatomiques du nerf médian permet d'éviter les complications les plus communes: décompression incomplète et lésions iatrogéniques de la branche thénarienne. Lors de l'évaluation pré-opératoire ainsi que lors de la révision post-opératoire il faut envisager la possibilité d'une double innervation thénarienne.
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Stančić, M.F., Eškinja, N. & Stošić, A. Anatomical variations of the median nerve in the carpal tunnel. International Orthopaedics 19, 30–34 (1995). https://doi.org/10.1007/BF00184911
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DOI: https://doi.org/10.1007/BF00184911