ePlasty: Vol. 19
Anatomic Landmarks to Locate the Median Nerve for Safe Wrist Block or Carpal Tunnel Steroid Injection
Ron Brooks, MD, Amanda Kistler, MD, Saeed Chowdhry, MD, Andrew Swiergosz, BS, Katharina Perlin, BS, Morton L. Kasdan, MD, and Bradon J. Wilhelmi, MD

Division of Plastic Surgery, University of Louisville, Louisville


Correspondence: kistler.amanda@gmail.com
Keywords: carpal tunnel syndrome, injection, iatrogenic injury, median nerve injury, wrist block

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 li .......