[Anatomic bases of the surgical approach to the carpal tunnel. A propos of 50 dissections].

Abstract

After a classic dissection of 50 wrists in black african cadavers, we have studied carpal tunnel anatomy for therapeutic deductions. By a wide anterior incision following the longitudinal axis of the third finger remounting the inferior third of the forearm we studied both the anatomical limits specially the transcarpal ligament, the volare carpal ligament and also median nerve and flexores digitorum tendons. We have observed in 2 cases an ectopic second lumbrical muscle inside the carpal tunnel; we found numerous variations of the collateral and terminal branches of median nerve; we concluded that it is difficult to definitively establish the cartography of the terminal branches of median nerve. However our anatomical observations allowed us to choose larger and more medial surgical approach of the carpal tunnel to avoid the following complications: incomplete section of the carpal ligament, damages of collateral branches of median nerve, dislocation of flexor tendons of index and middle fingers, ignorance of anomalous muscle.