Skip to main content
Log in

The clinical anatomy of the communications between the radial and ulnar nerves on the dorsal surface of the hand

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Sensations of the dorsal surface of the hand are supplied by the radial and ulnar nerves with the boundary between these two nerves classically being the midline of the fourth digit. Overlap and variations of this division exist and a communicating branch (RUCB) between the radial and ulnar nerves could potentially explain variations in the sensory examination of the dorsal hand. The aim of this study was to examine the origin and distribution of the RUCB thereby providing information that may potentially decrease iatrogenic injury to this connection. We grossly examined 200 formalin-fixed adult human hands. A RUCB was found to be present in 120 hands (60%). Of the specimens with RUCBs, we were able to identify four notable types. Type I (71, 59.1%) originated proximally from the radial nerve and proceeded distally to join the ulnar nerve. Type II (23, 19.1%) originated proximally from the ulnar nerve and proceeded distally to join the radial nerve. Type III (4, 3.3%) traveled perpendicularly between the radial and ulnar nerves so that it was not possible to determine which nerve served as its point of origin. Type IV (18.3%) had multiple RUCBs arising from both the radial and ulnar nerves. With the continual development of new surgical techniques and the ongoing effort to decrease postoperative complications, it is hoped that this study will provide useful information to both anatomists and surgeons.

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.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Anson BJ (1950) An atlas of human anatomy. Saunders, Philadelphia, p 170

    Google Scholar 

  2. Auerbach DM, Collins ED, Kunkle KL, Monsanto EH (1994) The radial sensory nerve: an anatomic study. Clin Orthop Relat Res 308:241–249

    PubMed  Google Scholar 

  3. Bas H, Kleinert JM (1999) Anatomic variations in sensory innervation of the hand and digits. J Hand Surg [Am] 24:1171–1184

    Article  CAS  Google Scholar 

  4. Beattie JR, Ross MA (1993) Electrophysiologic assessment of the dorsal ulnar cutaneous nerve reveals anatomic variation (medial location) is common. Muscle Nerve 16:1094–1095

    Google Scholar 

  5. Botte MJ, Cohen MS, Lavernia CJ, Schroeder HP, Gellman H, Zinberg EM (1990) The dorsal branch of the ulnar nerve: an anatomic study. J Hand Surg [Am] 5:603–607

    Article  Google Scholar 

  6. Casoli V, Verolino P, Pelissier P, Kostopoulos E, Caix P, Delmas V, Martin D, Baudet J (2004) The retrograde neurocutaneous island flap of the dorsal branch of the ulnar nerve: anatomical basis and clinical application. Surg Radiol Anat 26:8–13

    Article  PubMed  CAS  Google Scholar 

  7. Clemente CD (ed.) (1985) Gray’s anatomy. 30th Am. edn., Williams and Wilkins, Baltimore, p.731

  8. Garibaldi SG, Nucci A (2000) Dorsal cutaneous branch of the ulnar nerve: an appraisal on the anatomy, injuries and application of conduction velocity studies in diagnosis. Arq Neuropsiquiatr 58:637–641

    PubMed  CAS  Google Scholar 

  9. Greene TL, Steichen JB (1985) Digital nerve grafting using the dorsal sensory branch of 267 the ulnar nerve. J Hand Surg [Br] 10:37–40

    CAS  Google Scholar 

  10. Grossman JA, Rapaport L (1998) The dorsal cutaneous branch of the ulnar nerve: an anatomic clarification with six case reports. Ann Chir Main 17:154–158

    Article  CAS  Google Scholar 

  11. Hoffman MD, Mitz M, Luisi M, Melville BR (1988) Paired study of the dorsal cutaneous ulnar and superficial radial sensory nerves. Arch Phys Med Rehabil 69:591–594

    PubMed  CAS  Google Scholar 

  12. Ikiz ZA, Ucerler H (2004) Anatomic characteristics and clinical importance of the superficial branch of the radial nerve. Surg Radiol Anat 26:453–458

    Article  PubMed  Google Scholar 

  13. Kim YS (2001) Innervation of metacarpophalangeal joint and distal interphalangeal joint: an anatomical and histological study. Kaibogaku Zasshi 76:313–322

    PubMed  CAS  Google Scholar 

  14. Loukas M, Hullet J, Louis RG, Holdman S, Holdman D (2006) The gross anatomy of the extrathoracic course of the intercostobrachial nerve. Clin Anat 19:106–111

    Article  PubMed  Google Scholar 

  15. Mok D, Nikolis A, Harris PG (2006) The cutaneous innervation of the dorsal hand: detailed anatomy with clinical applications. J Hand Surg [Am] 4:656–574

    Google Scholar 

  16. Schaeffer JP (1942) Morris’ human anatomy. A complete systematic treatise. 10th edn., The Blakiston Company, Philadelphia, p 1108

    Google Scholar 

  17. Standring S, Ellis H, Healy C, Johnson D, Williams A (eds) (2005) Diaphragm and phrenic nerve in Gray’s anatomy. 39th edn., Elsevier Churchill Livingstone, London, p 1084

  18. Stappaerts KH, Van Hees J, Van Den Broeck EA (1996) Peripheral cutaneous nerve distribution to the fingers. Physiother Res Int 1:41–49

    Article  PubMed  CAS  Google Scholar 

  19. Stopford JSB (1918) The variation in distribution of the cutaneous nerves of the hand and digits. J Anat 53:18–24

    Google Scholar 

  20. Tellioglu AT, Sensoz O (1998) The dorsal branch of the digital nerve: an anatomic study and clinical applications. Ann Plast Surg 40:145–148

    Article  PubMed  CAS  Google Scholar 

  21. Tubbs RS, Salter EG, Sheetz J, Zehren S, Lee DH, Oakes J, Oakes WJ (2005) Novel surgical approach to carpal tunnel syndrome: cadaveric feasibility study. Clin Anat 18:350–356

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marios Loukas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Loukas, M., Louis, R.G., Wartmann, C.T. et al. The clinical anatomy of the communications between the radial and ulnar nerves on the dorsal surface of the hand. Surg Radiol Anat 30, 85–90 (2008). https://doi.org/10.1007/s00276-008-0304-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-008-0304-y

Keywords

Navigation