The anatomical landmarks effective in the localisation of the median nerve during orthopaedic procedures.

BACKGROUND

The aim of this study was to create a safe zone for surgeons who perform procedures in the wrist to avoid iatrogenic damage to the median nerve (MN) by identifying anatomical landmarks using ultrasound (USG).

MATERIALS AND

METHODS

We measured the distances between the MN and two easily identifiable anatomical landmarks at the level of the proximal border of carpal ligament using USG.

RESULTS

A total of 57 volunteers (n = 114 upper limbs) were included in this study. Our main findings revealed that the distance from the flexor carpi radialis tendon to MN (FCR-MN) was 7.87 mm (95% confidence interval 7.37-8.37) and the distance from flexor carpi ulnaris tendon to MN (FCU-MN) was 19.09 mm (95% confidence interval 18.51-19.67).

CONCLUSIONS

The tendons of FCR and FCU are easily identifiable landmarks that can be distinguished using simple palpation. Based on our USG findings, the area around FCR should be carefully navigated to avoid iatrogenic injury to the MN during surgical procedures around the carpal tunnel.