Skip to main content
Log in

Bifid median nerve as a determinant of carpal tunnel syndrome recurrence after endoscopic procedures. A case report

  • Case Report
  • Published:
Journal of Orthopaedics and Traumatology Submit manuscript

Abstract

A number of complications have been associated with endoscopic technique in treating carpal tunnel syndrome (CTS). We observed a female patient who had previously undergone endoscopic surgery for CTS. Shortly after surgery, this patient complained of pain, numbness and strength deficiency, as severe as it was before the operation. A new, open, surgical procedure was performed. During this second-look surgery, we found a bifid median nerve, which divided into two branches at the second third of the forearm, proximal to the flexor retinaculum. We strongly suggest a careful exploration of the median nerve in the carpal tunnel. Moreover, we believe that an extensive preoperative assessment of median nerve morphology and function is mandatory prior to endoscopic approach in treating CTS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lanz U (1977) Anatomical variations of the median nerve in the carpal tunnel. J Hand Surg Am 2(1):44–53

    PubMed  CAS  Google Scholar 

  2. Schultz RJ, Endler PM, Huddleston HD (1973) Anomalous median nerve and an anomalous muscle belly of the first lumbrical associated with carpal tunnel syndrome. J Bone Joint Surg Am 55(8):1744–1746

    PubMed  CAS  Google Scholar 

  3. Amadio PC (1987) Bifid median nerve with a double compartment within the transverse carpal canal. J Hand Surg Am 12(3):366–368

    PubMed  CAS  Google Scholar 

  4. Eversmann WW (1988) Entrapment and compression neuropathies. In: Green DP (ed) Operative hand surgery, 2nd edn. Churchill Livingstone, New York, pp 1434–1435

    Google Scholar 

  5. Szabo RM, Pettey J (1994) Bilateral median nerve bifurcation with an accessory compartiment within the carpal tunnel. J Hand Surg Br 19(1):22–23

    Article  PubMed  CAS  Google Scholar 

  6. Propeck T, Quinn TJ, Jacobson JA et al (2000) Sonography and MR imaging of bifid median nerve with anatomic and histologic correlation. AJR Am J Roentgenol 175(6):1721–1725

    PubMed  CAS  Google Scholar 

  7. Iannicelli E, Almberger M, Chianta GA et al (2001) Bifid median nerve in the carpal tunnel: integrated imaging. Radiol Med 101(6):456–458

    CAS  Google Scholar 

  8. Davlin LB, Aulicino PL, Bergfield TL (1992) Anatomical variations of the median nerve at the wrist. Orthop Rev 21(8):955–959

    PubMed  CAS  Google Scholar 

  9. Artico M, Cervoni L, Stevanato G et al (1995) Bifid median nerve: report of two cases. Acta Neurochir Wien 136(3–4):160–162

    Article  PubMed  CAS  Google Scholar 

  10. Artico M, De Santis S, Cavallotti D et al (2000) Anatomical variations of the ulnar and median nerves in the upper limb. Ital J Anat Embryol 105(3):189–200

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. Cellocco.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rossi, C., Cellocco, P. & Costanzo, G. Bifid median nerve as a determinant of carpal tunnel syndrome recurrence after endoscopic procedures. A case report. J Orthopaed Traumatol 4, 92–94 (2003). https://doi.org/10.1007/BF02637323

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02637323

Key words

Navigation