Variations of Formation, Distribution and Communications of Median Nerve in Fetal Cadavers

Abstract

Objective: Variations of the median nerve (MN) are important for clinical and surgical approaches. In this study, it was aimed to determine the formation, distribution and communication of the MN in fetal cadavers.Material and Method: This study was carried out on 80 upper extremities obtained from 40 spontaneously aborted human fetuses (22 females, 18 males) aged between 18 and 40 weeks. Median, ulnar and musculocutaneous nerve (MSCN) and their branches were identified and distribution of their branches was determined. The distribution, formation and communications of the MN were examined. Results: In this study, it was seen that the MN was composed of three roots in the 6 (7.5%) of 80 upper limbs. It was also found that the MN innervated the flexor muscles of the arm in two extremities despite MSCN was present (2.5%). It has also been determined that the MN innervated the flexor muscles of the arm in one extremity where MSCN was absent (1.25%). In addition, communications between the MSCN and the MN was detected in 3 (3.75%) extremities. Finally, in our study, Martin-Gruber communication was found 3.75% while Marinacci communication was not determined. Conclusions: This study identified variations and communications of the MN by means of fetal cadaveric dissection. These variations will adversely affect the correct diagnosis and treatment planning in upper extremity injuries. Therefore, precise knowledge of the variations and communications of the MN will be useful for surgeons to avoid iatrogenic injuries during surgical interventions in this region.