CC BY 4.0 · J Brachial Plex Peripher Nerve Inj 2020; 15(01): e1-e4
DOI: 10.1055/s-0039-3402734
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Median Nerve Variation: A Complete Spin before Terminal Branching

Amgad S. Hanna
1  Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
Zhikui Wei
2  Department of Neurology, Vanderbilt University, Nashville, Tennessee, United States
Barbara A. Hanna
3  College of Letter and Science (Premed), Undergraduate Student, University of Wisconsin, Madison, Wisconsin, United States
› Author Affiliations
Further Information

Publication History

03 June 2019

28 August 2019

Publication Date:
12 February 2020 (online)


Median nerve anatomy is of great interest to clinicians and scientists given the importance of this nerve and its association with diseases. A rare anatomical variant of the median nerve in the distal forearm and wrist was discovered during a cadaveric dissection. The median nerve was deep to the flexor digitorum superficialis (FDS) in the carpal tunnel. It underwent a 360-degree spin before emerging at the lateral edge of FDS. The recurrent motor branch moved from medial to lateral on the deep surface of the median nerve, as it approached the distal carpal tunnel. This variant doesn't fall into any of Lanz's four groups of median nerve anomalies. We propose a fifth group that involves variations in the course of the median nerve. This report underscores the importance of recognizing variants of the median nerve anatomy in the forearm and wrist during surgical interventions, such as for carpal tunnel syndrome.