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Anatomic Landmarks to Locate the Median Nerve for Safe Wrist Block or Carpal Tunnel Steroid Injection
Introduction: Carpal tunnel syndrome is the most common entrapment neuropathy involving the upper extremity. As such, various nonoperative techniques have been developed to aid in management of mild to moderate disease, including local steroid injection. However, definitive guidelines for needle/inj...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Open Science Company, LLC
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727415/ https://www.ncbi.nlm.nih.gov/pubmed/31501688 |
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author | Brooks, Ron Kistler, Amanda Chowdhry, Saeed Swiergosz, Andrew Perlin, Katharina Kasdan, Morton L. Wilhelmi, Bradon J. |
author_facet | Brooks, Ron Kistler, Amanda Chowdhry, Saeed Swiergosz, Andrew Perlin, Katharina Kasdan, Morton L. Wilhelmi, Bradon J. |
author_sort | Brooks, Ron |
collection | PubMed |
description | Introduction: Carpal tunnel syndrome is the most common entrapment neuropathy involving the upper extremity. As such, various nonoperative techniques have been developed to aid in management of mild to moderate disease, including local steroid injection. However, definitive guidelines for needle/injection location have not been defined, especially in relation to diminishment of iatrogenic injury to the median nerve. Methods: A cadaveric study was designed to determine the average width of the median nerve, as well as its location specifically in relation to the palmaris longus (if present), the flexor carpi radialis, and the midpoint of the wrist. All measurements were obtained at the radial tip of the interstyloid line. Results: Data demonstrated that the average width of the median nerve was 7.85 mm and that it lies ulnar in location to the palmaris longus (3 mm), as well as the midpoint of the wrist at the radial tip of the interstyloid line (0.43 mm). Furthermore, the distance between the median nerve and the flexor carpi radialis was measured to be 9.57 mm. Outcomes: Therefore, injection location should be radial with respect to the palmaris longus and the midline of the wrist. It can be just ulnar to the flexor carpi radialis tendon or between 8 and 10 mm radial to the midpoint of the wrist in order to prevent median nerve injection and direct trauma to the nerve. |
format | Online Article Text |
id | pubmed-6727415 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Open Science Company, LLC |
record_format | MEDLINE/PubMed |
spelling | pubmed-67274152019-09-09 Anatomic Landmarks to Locate the Median Nerve for Safe Wrist Block or Carpal Tunnel Steroid Injection Brooks, Ron Kistler, Amanda Chowdhry, Saeed Swiergosz, Andrew Perlin, Katharina Kasdan, Morton L. Wilhelmi, Bradon J. Eplasty Journal Article Introduction: Carpal tunnel syndrome is the most common entrapment neuropathy involving the upper extremity. As such, various nonoperative techniques have been developed to aid in management of mild to moderate disease, including local steroid injection. However, definitive guidelines for needle/injection location have not been defined, especially in relation to diminishment of iatrogenic injury to the median nerve. Methods: A cadaveric study was designed to determine the average width of the median nerve, as well as its location specifically in relation to the palmaris longus (if present), the flexor carpi radialis, and the midpoint of the wrist. All measurements were obtained at the radial tip of the interstyloid line. Results: Data demonstrated that the average width of the median nerve was 7.85 mm and that it lies ulnar in location to the palmaris longus (3 mm), as well as the midpoint of the wrist at the radial tip of the interstyloid line (0.43 mm). Furthermore, the distance between the median nerve and the flexor carpi radialis was measured to be 9.57 mm. Outcomes: Therefore, injection location should be radial with respect to the palmaris longus and the midline of the wrist. It can be just ulnar to the flexor carpi radialis tendon or between 8 and 10 mm radial to the midpoint of the wrist in order to prevent median nerve injection and direct trauma to the nerve. Open Science Company, LLC 2019-07-29 /pmc/articles/PMC6727415/ /pubmed/31501688 Text en Copyright © 2019 The Author(s) http://creativecommons.org/licenses/by/2.0/ This is an open-access article whereby the authors retain copyright of the work. The article is distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Journal Article Brooks, Ron Kistler, Amanda Chowdhry, Saeed Swiergosz, Andrew Perlin, Katharina Kasdan, Morton L. Wilhelmi, Bradon J. Anatomic Landmarks to Locate the Median Nerve for Safe Wrist Block or Carpal Tunnel Steroid Injection |
title | Anatomic Landmarks to Locate the Median Nerve for Safe Wrist Block or Carpal Tunnel Steroid Injection |
title_full | Anatomic Landmarks to Locate the Median Nerve for Safe Wrist Block or Carpal Tunnel Steroid Injection |
title_fullStr | Anatomic Landmarks to Locate the Median Nerve for Safe Wrist Block or Carpal Tunnel Steroid Injection |
title_full_unstemmed | Anatomic Landmarks to Locate the Median Nerve for Safe Wrist Block or Carpal Tunnel Steroid Injection |
title_short | Anatomic Landmarks to Locate the Median Nerve for Safe Wrist Block or Carpal Tunnel Steroid Injection |
title_sort | anatomic landmarks to locate the median nerve for safe wrist block or carpal tunnel steroid injection |
topic | Journal Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727415/ https://www.ncbi.nlm.nih.gov/pubmed/31501688 |
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