Objective
To evaluate the relationship between the palmar cutaneous branch of median nerve (PCBMN) and surrounding anatomical structures by using high-resolution ultrasound (HRUS) to assess the risk of PCBMN injury.
Methods
The PCBMN course and the characteristics of bilateral distal forearms and wrists of 30 healthy volunteers were identified. The distance between PCBMN and other anatomical structures at three different levels along its course were measured using HRUS. Moreover, the depth of PCBMN from skin and its cross-sectional area (CSA) were measured.
Results
HRUS showed the PCBMN in all subjects. PCBMN branched off from the radial aspect of the median nerve (MN) at 4.69±0.89 cm proximal to the bistyloid line (BSL) and extended radially toward the flexor carpi radialis (FCR) tendon. PCBMN was within the ulnar edge of FCR tendon sheath, and became more superficial and perforated the antebrachial fascia between the FCR tendon laterally and the palmaris longus (PL) tendon medially. PCBMN was located at 4.08±0.72 mm on the ulnar aspect of the FCR tendon and 4.78±0.36 mm radially on the PL tendon at BSL. At the distal wrist crease level, the PCBMN was located at 5.68±0.58 mm on the ulnar side of the FCR tendon. The PCBMN depth from skin at BSL and its branching point was 1.92±0.41 and 7.95±0.79 mm, respectively. The PCBMN CSA was 0.26±0.15 mm² at BSL.
Conclusion
HRUS can be used to identify PCBMN and its relationship with other anatomical structures. Our data can be used to predict PCBMN location, and prevent complications associated with invasive procedures involving the wrist.

Citations

• Sonography of the Thenar Motor Branch of the Median Nerve
  Márcio Luís Duarte, Ocacir de Souza Reis Soares, Jean‐Louis Brasseur
  Journal of Ultrasound in Medicine.2025; 44(9): 1691.     CrossRef
• Ultrasonographic Assessment of Median Nerve and Carpal Tunnel Variations
  Eric J. Super, Marin S. Smith, Matthew E. Miller, Jay Smith, Xiaoning Yuan
  Journal of Ultrasound in Medicine.2025; 44(10): 1819.     CrossRef
• Pilot Study: Evaluating Pillar Pain Outcomes Following Carpal Tunnel Release Surgery With Fractional CO2 Laser Therapy
  Caroline J. Cushman, Brennon G. Henderson, Wm. Zachary Salter, Andrew F. Ibrahim, Evan J. Hernandez, Brendan J. MacKay
  Plastic and Reconstructive Surgery - Global Open.2025; 13(10): e7189.     CrossRef
• Pillar Pain After Minimally Invasive and Standard Open Carpal Tunnel Release: A Systematic Review and Meta-analysis
  Annora Ai-Wei Kumar, Matthew Lawson-Smith
  Journal of Hand Surgery Global Online.2024; 6(2): 212.     CrossRef
• Transbrachial Artery as Single or Combined Approach for Complex Interventions in Patients with Peripheral Artery Disease
  Jiawen Wu, Jinyan Xu, Qingyuan Yu, Cheng Chen, Yu Xiao, Junmin Bao, Liangxi Yuan
  Annals of Vascular Surgery.2024; 102: 209.     CrossRef
• Cadaveric Study of Thread Carpal Tunnel Release Using Newly Developed Thread, With a Histologic Perspective
  Hae-Yeon Park, Jae Min Kim, In Jong Kim, Minsuk Kang, Jung Ryul Ham, Yong Seok Nam
  Annals of Rehabilitation Medicine.2023; 47(1): 19.     CrossRef
• Ultrasound Imaging and Guidance for Distal Peripheral Nerve Pathologies at the Wrist/Hand
  Wei-Ting Wu, Ke-Vin Chang, Yu-Chun Hsu, Yuan-Yuan Tsai, Kamal Mezian, Vincenzo Ricci, Levent Özçakar
  Diagnostics.2023; 13(11): 1928.     CrossRef
• Modified Carpal Tunnel Release
  Tarik Mujadzic, Harold I. Friedman, Mirza M. Mujadzic, Charles Gober, Elliot Chen, Abdelaziz Atwez, Martin Durkin, Mirsad M. Mujadzic
  Annals of Plastic Surgery.2021; 86(6S): S503.     CrossRef
• Surgical approaches and applied anatomy of the wrist
  Sarah Henning, Matthew Weston, Michael David
  Orthopaedics and Trauma.2021; 35(4): 174.     CrossRef
• Prevention and Management of Complications of Tissue Flaps
  Travis J. Miller, Christopher V. Lavin, Arash Momeni, Derrick C. Wan
  Surgical Clinics of North America.2021; 101(5): 813.     CrossRef
• Is Palmar Cutaneous Branch of the Median Nerve More Swollen in Carpal Tunnel Syndrome?
  Ha Mok Jeong, Young Ha Jeong, Joon Shik Yoon
  Annals of Rehabilitation Medicine.2021; 45(4): 325.     CrossRef
• Anatomy of the nerves, vessels, and muscular compartments of the forearm, as revealed by high-resolution ultrasound. Part 1: overall structure and forearm compartments
  Áurea V. R. Mohana Borges, Sergio A. L Souza
  Radiologia Brasileira.2021; 54(6): 388.     CrossRef
• Ultrasound Findings in Less Frequent Causes of Carpal Tunnel Syndrome
  Stefano Bianchi, Douglas F. Hoffman, Giorgio Tamborrini, Pierre‐Alexandre Poletti
  Journal of Ultrasound in Medicine.2020; 39(12): 2469.     CrossRef