scholarly journals Richie Cannieu Anastomosis: A Case Report

2014 ◽  
Vol 25 (2) ◽  
pp. 56-58
Author(s):  
K Sreejith ◽  
TR Sudhil ◽  
IN Krishnaprasad ◽  
P Sreedevi Menon
Keyword(s):  
Case Report ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Surgical Intervention ◽  
Correct Diagnosis ◽  
Human Anatomy ◽  
Deep Branch ◽  
Normal Human ◽  
Ulnar Nerve Injury ◽  
Electrodiagnostic Study

Abstract To perform or interpret an electrodiagnostic study, one should have a thorough knowledge about the normal human anatomy. Along with that, one should keep in mind the possibility of various anastomoses which can occur between different nerves. Richie Cannieu anastomosis is an anomalous ulnar to median communication in the palm between the deep branch of the ulnar nerve and the recurrent branch of the median nerve. Such an anastomosis in a setting of median or ulnar nerve injury can produce confusing clinical and electrodiagnostic findings. Correct diagnosis is important especially before planning any surgical intervention. Here we report a case of Richie Cannieu anastomosis to highlight the importance of knowing about such anastomoses.

Carpal Tunnel Syndrome Caused by a Simple Ganglion

HAND ◽  
1981 ◽  
Vol os-13 (2) ◽  
pp. 164-166 ◽  
Author(s):  
F. J. Harvey ◽  
J. S. Bosanquet
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Peripheral Nerves ◽  
Nerve Compression ◽  
Median Nerve Compression ◽  
Deep Branch ◽  
Tunnel Syndrome

The compression of peripheral nerves by simple ganglia is a well recognized and documented clinical entity. It has been reported where ganglia have been associated with the ankle, knee and elbow joints (D. M. Brooks, 1952). It is probably best known in compression of the deep branch of the ulnar nerve in the wrist, first described by Seddon (Seddon H. J. 1952). Median nerve compression at the wrist, however, that causes a carpal tunnel syndrome would appear to be well recognized but poorly documented. Brooks (1952) described a case and until now, no others have been recorded in the literature. This case report describes such median nerve involvement with some interesting features.

scholarly journals Flexor Pollicis Brevis Muscle. Anatomical Study and Clinical Implications

2017 ◽  
Vol 11 (1) ◽  
pp. 1321-1329
Author(s):  
Edie Benedito Caetano ◽  
Yuri da Cunha Nakamichi ◽  
Renato Alves de Andrade ◽  
Maico Minoru Sawada ◽  
Mauricio Tadeu Nakasone ◽  
...  
Keyword(s):  
Medical School ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Anatomical Study ◽  
Sao Paulo ◽  
Clinical Implications ◽  
Normal Pattern ◽  
Anatomical Dissection ◽  
Deep Branch ◽  
Catholic University

Introduction: This paper reports anatomical study of nature, incidence, innervation and clinical implications of Flexor Pollicis Brevis muscle (FPB). Material and Methods: The anatomical dissection of 60 limbs from 30 cadavers were performed in the Department of Anatomy of Medical School of Catholic University of São Paulo. Results: The superficial head of FPB has been innervated by the median nerve in 70% and in 30% it had double innervation. The deep head of FPB were absent in 14%, in 65%, occurred a double innervation. In 17.5% by deep branch of ulnar nerve and in 3.6% by recurrent branch of median nerve. Conclusion: The pattern of innervation more frequent in relationship to the flexor pollicis brevis muscle and should be considered as a normal pattern is that superficial head receives innervation of branches of median nerve and the deep head receives innervation of ulnar and median nerve.

Ulnar Nerve Laceration — a Complication of Carpal Tunnel Decompression: Case Report and Review of the Literature

1987 ◽  
Vol 12 (2) ◽  
pp. 239-241
Author(s):  
K. J. FAVERO ◽  
P. T. GROPPER
Keyword(s):  
Case Report ◽  
Nerve Injury ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Peripheral Nerve Injury ◽  
Review Of The Literature ◽  
Carpal Tunnel Surgery ◽  
Tunnel Syndrome ◽  
Ulnar Nerve Injury

Complications of peripheral nerve injury arising from the surgical treatment of carpal tunnel syndrome are not uncommon. No documented report of the association of ulnar nerve injury with carpal tunnel decompression has been found. This case-study describes partial laceration of the ulnar nerve as a complication of carpal tunnel surgery and reviews the literature on this subject.

scholarly journals Aberrant Positioning of the Ulnar Nerve Found During Carpal Tunnel Release: A Case Report

2019 ◽  
Author(s):  
David R. Veltre ◽  
Kelvin Naito ◽  
Xinning Li ◽  
Andrew B. Stein
Keyword(s):  
Case Report ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Distal Forearm ◽  
Anatomic Variations ◽  
Transverse Carpal Ligament ◽  
Iatrogenic Injuries ◽  
Flexor Retinaculum

Introduction: Aberrant positioning of the ulnar nerve volar to the transverse carpal ligament is a rare anatomic variation.Case Presentation: We present the case of a 55-year-old female with unique ulnar nerve anatomy that was discovered introperatively during carpal tunnel release.  The ulnar nerve was running directly adjacent to the median nerve in the distal forearm and as the median nerve traversed dorsal to the transverse carpal ligament (flexor retinaculum) to enter the carpal tunnel the ulnar nerve continued directly volar to this structure before angling towards Guyon’s Canal.  The unique ulnar nerve anatomy was successfully identified, carefully dissected and managed with a successful patient outcome.Conclusion: Variations of the anatomy at the level of the carpal tunnel are rare but do exist.  Awareness of these anatomic variations and adequate visualization of the ulnar nerve along with the surrounding structures is crucial to avoid iatrogenic injuries during carpal tunnel release. 

Missile-caused Ulnar Nerve Injuries: Outcomes of 128 Repairs

Neurosurgery ◽  
2004 ◽  
Vol 55 (5) ◽  
pp. 1120-1129 ◽  
Author(s):  
Zoran Roganovic
Keyword(s):  
Median Nerve ◽  
Nerve Injury ◽  
Ulnar Nerve ◽  
Nerve Repair ◽  
Successful Outcome ◽  
Neurosurgical Department ◽  
Military Medical Academy ◽  
Ulnar Nerve Injury ◽  
High Level ◽  
Sensorimotor Recovery

Abstract OBJECTIVE: This prospective study presents repair results after missile-caused ulnar nerve ruptures as well as factors influencing the outcomes. METHODS: Between 1991 and 1994, 128 casualties with missile-caused complete ulnar nerve injury were managed surgically in the Neurosurgical Department of the Belgrade Military Medical Academy. At least 4 years after surgery, we scored sensorimotor recovery, neurophysiological recovery, and patient judgment of the outcome. On the basis of the total score, we defined the final outcome as poor, insufficient, good, or excellent. The last two outcomes were considered to be successful. RESULTS: A successful outcome was obtained in 0% of high-level, 33.8% of intermediate-level, and 77.3% of low-level repairs (P< 0.001). On average, the nerve defect, preoperative interval, and patient age were lower for patients with a successful outcome than for those with an unsuccessful outcome (P= 0.004, P= 0.032, and P= 0.003, respectively). Worsening of the outcome was related to nerve defect longer than 4.5 cm, preoperative interval longer than 5.5 months, and age older than 23 years (P= 0.002, P= 0.034, and P= 0.023, respectively). A successful outcome occurred in 48.8% of patients repaired with direct suture and in 41.2% of patients repaired with a nerve graft (P> 0.05). A successful outcome also occurred 22.2% of combined ulnar-median nerve repairs and in 49.5% of isolated ulnar nerve repairs (P= 0.011). Repair level (P< 0.001), preoperative interval (P= 0.001), length of the nerve defect (P< 0.001), and associated median nerve rupture (P= 0.028) were independent predictors of a successful outcome. CONCLUSION: The outcome of ulnar nerve repair depends significantly on the repair level, preoperative interval, associated median nerve injury, length of the nerve defect, and age of the patient. High-level ulnar nerve repair is probably useless if performed in the classic manner.

scholarly journals Topographical, anatomical and neurosurgical aspects of "end-to-side" nerve repair

2021 ◽  
Vol 23 (1) ◽  
pp. 121-128
Author(s):  
A. Y. Nisht ◽  
Nikolay F. Fomin ◽  
Vladimir P. Orlov
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Lateral Surface ◽  
Peripheral Nerves ◽  
Radial Nerve ◽  
Surgical Techniques ◽  
Nerve Fibers ◽  
Individual Variability ◽  
Motor Branch ◽  
Deep Branch

The article presents the results of a comprehensive anatomical and experimental study of individual variability in the structure and topography of motor branches of peripheral nerves in relation to the justification of methods for selective reinnervation of tissues by the "end-to-side" neurorrhaphy. It was found that relatively longer branches of peripheral nerves with a small number of connecting inter-arm collaterals characteristic of narrow and long limbs create conditions for less traumatic mobilization of motor branches. In cases with relatively wide and short extremities mobilization of peripheral nerves is complicated by the presence of a large number of collateral branches and intra-trunk connections, which are often damaged when separate bundles that make up the mobilized branches of the donor or recipient nerve are isolated from the main nerve trunk. It has been shown that potential recipient nerves should be motor branches of peripheral nerves, the preservation of which is of fundamental importance for the function of the corresponding segment of the limb. To create conditions conducive to selective reinnervation of functionally significant muscle groups of the upper limb, we have developed, justified from anatomical positions, and tested in an experiment on anatomical material methods for connecting the distal motor branches of peripheral nerves by the "end-to-side" neurorrhaphy. The main idea of accelerated recovery of the thumb opposition in injuries of the median nerve is to reinnervate the muscles of the elevation of the I finger due to nerve fibers that are part of the deep branch of the ulnar nerve. For this purpose, surgical techniques have been developed for connecting the recurrent motor branch of the damaged median nerve mobilized at the level of the wrist with the edges of a surgically formed perineurium defect on the lateral surface of the bundles that make up the deep branch of the ulnar nerve. In another clinical situation, in patients with radial nerve injuries, for the muscle reinnervation, а method is proposed for neurotisation of the deep motor branch of the radial nerve by the end-to-side suture to the lateral surface of the median nerve. We assume that performing the "end-to-side" nerve suture at the level of the base of the hand in the cases of proximal damage to the median nerve will reduce the time of reinnervation of the muscles of the thumb elevation by 400450 days. Transposition of the deep branch of the damaged at the proximal level radial nerve with "end-to-side" neurorrhaphy to the median nerve by 250300 days (based on the total length of the shoulder and forearm, which is about 50 cm and the rate of regeneration of nerve fibers 1 mm per day). Accordingly, with higher injuries (brachial plexus), the gain in the time of reinnervation of the distal segments will be even greater. In our opinion, the results can be used as a basis for further clinical research on the development of methods for selective tissue reinnervation in cases with isolated injuries of the peripheral nerves.

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