|Objective: Originally, this image was used in a medical-legal malpractice defense case in which the plaintiff had temporarily lost sensation of the radial side of the distal portion of the 4th digit after surgery to relieve carpal tunnel syndrome. This rare palmar branch of the median nerve, which hand surgeons look for superficial to the transverse carpal ligament, diverged from the median nerve more proximally than usual, coursed within the inflamed flexor tendon sheath, and rejoined the radial branch of the median nerve distal to the operative site. The dashed line delineates the radial border of this branch so that it can be seen how difficult it would be to find this small nerve in this case. The cross section, at the level of the pisiform bone, shows the depth at which the nerve lies.
This continuous tone illustration was made based on a portion of the original exhibit and would be used in a hand surgery text to depict an abberrant example of the palmar branch of the median nerve.
References: Surgeon (defendant), artist's surgical sketches, Green's Operative Hand Anatomy, Callander's Surgical Anatomy, Netter's Atlas of Human Anatomy
Medium: Adobe Photoshop
Mode of Presentation/Audience: Surgical Atlas / Surgeons
All images ©2001 William W. Scavone. All Rights Reserved. Images are not