Lumbrical Muscles Neural Branching Patterns: A Cadaveric Study With Potential Clinical Implications
| Autor: | Raffaele De Caro, Filippo Cucinotta, Regina Sonda, Pierluigi Tos, Bruno Battiston, Stefano Geuna, Michele R. Colonna, Maria Piagkou, Antonina Fazio, Nikolaos A. Papadopulos, Mariarosaria Galeano, Cesare Tiengo, Konstantinos Natsis, Andrea Monticelli, Nikolaos Anastasopoulos, Andrea Porzionato, Alfio Luca Costa, Franco Bassetto, Paolo Titolo |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
anomaly
lumbrical muscle 030230 surgery Wrist Deep transverse metacarpal ligament 03 medical and health sciences 0302 clinical medicine Medicine Orthopedics and Sports Medicine Ulnar nerve 030222 orthopedics anomaly clinical implication lumbrical muscle lumbrical nerve variation business.industry Anatomy musculoskeletal system Unknown age Median nerve body regions clinical implication medicine.anatomical_structure lumbrical nerve Surgery variation Palm Cadaveric spasm business Palmar Region |
| Zdroj: | HAND. 17:839-847 |
| ISSN: | 1558-9455 1558-9447 |
| DOI: | 10.1177/1558944720963881 |
| Popis: | Background Lumbrical muscles originate in the palm from the 4 tendons of the flexor digitorum profundus and course distally along the radial side of the corresponding metacarpophalangeal joints, in front of the deep transverse metacarpal ligament. The first and second lumbrical muscles are typically innervated by the median nerve, and third and fourth by the ulnar nerve. A plethora of lumbrical muscle variants has been described, ranging from muscles’ absence to reduction in their number or presence of accessory slips. The current cadaveric study highlights typical and variable neural supply of lumbrical muscles. Materials Eight (3 right and 5 left) fresh frozen cadaveric hands of 3 males and 5 females of unknown age were dissected. From the palmar wrist crease, the median and ulnar nerve followed distally to their terminal branches. The ulnar nerve deep branch was dissected and lumbrical muscle innervation patterns were noted. Results The frequency of typical innervations of lumbrical muscles is confirmed. The second lumbrical nerve had a double composition from both the median and ulnar nerves, in 12.5% of the hands. The thickest branch (1.38 mm) originated from the ulnar nerve and supplied the third lumbrical muscle, and the thinnest one (0.67 mm) from the ulnar nerve and supplied the fourth lumbrical muscle. In 54.5%, lumbrical nerve bifurcation was identified. Conclusion The complex innervation pattern and the peculiar anatomy of branching to different thirds of the muscle bellies are pointed out. These findings are important in dealing with complex and deep injuries in the palmar region, including transmetacarpal amputations. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|