Al-Qattan Mohammad M, Al-Zahrani Khalid
Department of Surgery, King Saud University, 18097, Riyadh, 11415 Saudi Arabia.
National Hospital (Care), Riyadh, Saudi Arabia.
Eur J Plast Surg. 2017;40(3):259-262. doi: 10.1007/s00238-016-1271-x. Epub 2017 Jan 13.
The pre-ligamentous variant of the thenar motor branch (TMB) of the median nerve is extremely rare. In all previously reported cases, the branch arose from the radial or antero-radial aspect of the median nerve in the distal forearm and then pierced the antebrachial fascia to reach the thenar muscles. We report on a case in which the pre-ligamentous TMB not only arose from the ulnar side of the median nerve but it also remained deep to both the antebrachial fascia and the transverse carpal ligament until it reached the thenar muscles. The course of this variant puts the TMB at significant risk of injury during both open and endoscopic carpal tunnel release.
Level V, risk study.
正中神经鱼际运动支（TMB）的韧带前变异极为罕见。在所有先前报道的病例中，该分支起源于前臂远端正中神经的桡侧或前桡侧，然后穿过前臂筋膜到达鱼际肌。我们报告一例韧带前TMB不仅起源于正中神经的尺侧，而且在到达鱼际肌之前一直位于前臂筋膜和腕横韧带的深面。这种变异的走行使TMB在开放性和内镜下腕管松解术中都有遭受损伤的重大风险。
V级，风险研究。
