Folia morphologica · 2025
Ultrasound validation of surface localization for the recurrent motor branch of the median nerve: a cadaveric study.
СтатьяНазвание и аннотация: Перевод в очереди
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Wang Shi-Hao, Zhang Rui-Meng, Wang Jia-Yi, Sun Ye, Qin Xiang-Zheng
Аннотация
BACKGROUND: Rapid identification of the recurrent motor branch (RMB) of the median nerve (MN) via ultrasound is relatively challenging, and its timely accurate localisation facilitates early assessment. This study established a surface landmark-based coordinate system for RMB localisation and verified its effectiveness through cadaver dissection and high-resolution ultrasound (HRUS).
MATERIALS AND METHODS: Fifty embalmed wrist specimens were dissected to record RMB anatomical variations. A coordinate system was constructed with the distal wrist crease as the X-axis and the radial border of the ring finger as the Y-axis. Key RMB coordinate points were collected to define a target zone. High-resolution ultrasound evaluated the RMB detection rate within this zone in 20 volunteers, and 4 frozen wrist specimens were dissected to verify HRUS localisation accuracy.
RESULTS: The RMB was predominantly single-branched (76%), with 74% running extra-ligamentously, 72% penetrating the palmar aponeurosis fibrous layer, and 67% passing through the tendinous fibrous bundle of the flexor pollicis brevis (FPB) muscle. Key anatomical points of the RMB were concentrated at 11.34 mm from the X-axis (defined as the distal wrist crease) and 36.12 mm from the Y-axis (defined as the radial border of the ring finger). The volunteer detection rate was 73%, with 88% of HRUS-identifiable RMBs localised within the zone. Frozen specimen dissection confirmed 100% HRUS accuracy.
CONCLUSIONS: This coordinate system effectively predicts RMB distribution. Preoperative combination with HRUS facilitates rapid RMB identification and evaluation, potentially enhancing surgical safety.
MATERIALS AND METHODS: Fifty embalmed wrist specimens were dissected to record RMB anatomical variations. A coordinate system was constructed with the distal wrist crease as the X-axis and the radial border of the ring finger as the Y-axis. Key RMB coordinate points were collected to define a target zone. High-resolution ultrasound evaluated the RMB detection rate within this zone in 20 volunteers, and 4 frozen wrist specimens were dissected to verify HRUS localisation accuracy.
RESULTS: The RMB was predominantly single-branched (76%), with 74% running extra-ligamentously, 72% penetrating the palmar aponeurosis fibrous layer, and 67% passing through the tendinous fibrous bundle of the flexor pollicis brevis (FPB) muscle. Key anatomical points of the RMB were concentrated at 11.34 mm from the X-axis (defined as the distal wrist crease) and 36.12 mm from the Y-axis (defined as the radial border of the ring finger). The volunteer detection rate was 73%, with 88% of HRUS-identifiable RMBs localised within the zone. Frozen specimen dissection confirmed 100% HRUS accuracy.
CONCLUSIONS: This coordinate system effectively predicts RMB distribution. Preoperative combination with HRUS facilitates rapid RMB identification and evaluation, potentially enhancing surgical safety.