Department of Neurology, The Assaf Harofeh Medical Center, Zerifin, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Neurophysiol Clin. 2013 Apr;43(2):105-8. doi: 10.1016/j.neucli.2012.12.001. Epub 2013 Feb 28.
Three patients presented with painful paraesthesias in the dorsomedial aspect of the hand after removal of a ganglion cyst of the dorsal lower third of the forearm. This hand territory is usually innervated by the dorsal cutaneous branch of the ulnar nerve (DCU) but here it was innervated by a branch of the radial superficial nerve (RS). Consequently, we aimed to examine the frequency of this variant in the general population.
Both RS and DCU were stimulated in the forearm and sensory response recorded from the dorsomedial skin area of the hand in the three patients and 100 normal controls.
In all three patients, the RS nerve innervated the dorsomedial hand bilaterally. Nineteen out of 100 controls demonstrated variants of dorsomedial skin innervation of the hand on nerve conduction studies: 12 unilaterally and seven bilaterally. Among them, 13 individuals had mixed innervation by both RS and DCU and six by the RS nerve only.
Nerve conduction studies of both RS and DCU with sensory response recording on the dorsomedial hand area should be considered before surgical procedures on the dorsal lower forearm in order to prevent iatrogenic postoperative sensory nerves lesions.
三名患者在前臂背下部腱鞘囊肿切除术后出现手部背侧内侧疼痛感觉异常。该手部区域通常由尺神经背侧皮支（DCU）支配，但此处由桡浅神经分支（RS）支配。因此，我们旨在研究这种变异在普通人群中的发生率。
在三名患者和 100 名正常对照中，在前臂同时刺激 RS 和 DCU，并记录手部背侧内侧皮肤的感觉反应。
在所有三名患者中，RS 神经双侧支配手部背侧内侧。100 名对照中有 19 人在神经传导研究中表现出手部背侧内侧皮肤的神经支配变异：12 人单侧，7 人双侧。其中，13 人存在 RS 和 DCU 的混合支配，6 人仅由 RS 神经支配。
在进行背下部前臂手术之前，应考虑进行 RS 和 DCU 的神经传导研究，并在手背侧内侧区域记录感觉反应，以防止医源性术后感觉神经损伤。
