ePlasty: Vol. 8
Variations in the Anatomy of the Third Common Digital Nerve and Landmarks to Avoid Injury to the Third Common Digital Nerve With Carpal Tunnel Release
Nitin J. Engineer, MD, Ron Hazani, MD, Arian Mowlavi, MD, Michael W. Neumeister, MD, W. P. Andrew Lee, MD, and Bradon J. Wilhelmi, MD

Division of Plastic and Reconstructive Surgery, School of Medicine, University of Louisville, Louisville, KY

Presented at the American Association for Hand Surgery's annual meeting at Palm Springs, California, January 2004.

Correspondence: n_engineer@yahoo.com

Background: The third common digital nerve (TCDN) has been described as the most commonly injured digital nerve during carpal tunnel release (CTR). Anatomic variations of the origin and course of the TCDN from the median nerve may place this structure at risk. Anatomic landmarks may be useful to predict the location of the TCDN to minimize the risk for injury to this structure during CTR. Methods: Twenty cadaveric hands were used to determine the origin and course of the TCDN. The origin of the TCDN from the median nerve was identified in relation to the transverse carpal ligament (TCL), cardinal line, and superficial palmar arch. The course of the TCDN was inspected in relation to the scaphoid tubercle and ring finger. Results: Three specific anatomic variations for the origin of the TCDN were iden .......