Superficial palmar communicating branches between the median and ulnar nerves: morphometric study

Detailed knowledge of the location of the neurovascular structures of the palm is important to avoid iatrogenic injuries during surgical interventions. A morphometric study was undertaken to determine the relationship between the superficial palmar communicating branch (CB) and important anatomical landmarks such as the wrist crease (WC), bistyloid line (BSL) and the transverse carpal ligament (TCL) in 98 formalin-fixed cadaveric palms. The proximal attachment of the CB was found between 25.9–60.3% of the distances between the 3rd metacarpophalangeal joint (MCPJ) and WC and 34.5–60.4% of the distances between the 3rd MCPJ and BSL. The distal attachment was found between 33.6–79.3% of the distances between the 3rd MCPJ and the WC and 41.8–75.4% of the distances between the 3rd MCPJ and BSL. The proximal and distal attachments were 5.3 ± 5.2 mm (range: −10.6–19.4) and 16.4 ± 6.4 mm (range: 1.3–39.5) to the TCL respectively. A risk zone where the CB is likely to be found was identified. Knowledge of the location and range of possible CBs patterns will aid clinicians to better assess and diagnose cases pre-operatively, recognize and preserve CBs intra-operatively, and accurately evaluate complications post-operatively.