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Kaplan anastomosis of the ulnar nerve: a case report.

Paraskevas G, Ch Gekas C, Tzaveas A, Spyridakis I, Stoltidou A, Ph Tsitsopoulos P - J Med Case Rep (2008)

Bottom Line: The sensory innervation of the hand is usually unvarying and anomalies in this area are uncommon.We report the case of a rare ulnar nerve branch called a Kaplan anastomosis, which anastomosed the dorsal cutaneous branch with the ulnar nerve prior to its bifurcation into the superficial and deep ramus.Many authors have reported unusual ulnar nerve branches and knowledge of these anatomical variations is important for the interpretation of pain and sensory loss in the area sustained during injuries or surgical procedures.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Anatomy, Medical Faculty, Aristotle University of Thessaloniki, Thessaloniki, Greece. g_paraskevas@yahoo.gr

ABSTRACT

Introduction: The sensory innervation of the hand is usually unvarying and anomalies in this area are uncommon.

Case presentation: We report the case of a rare ulnar nerve branch called a Kaplan anastomosis, which anastomosed the dorsal cutaneous branch with the ulnar nerve prior to its bifurcation into the superficial and deep ramus.

Conclusion: Many authors have reported unusual ulnar nerve branches and knowledge of these anatomical variations is important for the interpretation of pain and sensory loss in the area sustained during injuries or surgical procedures. Our finding is the fourth case of a Kaplan anastomosis to be described in the literature.

No MeSH data available.


Related in: MedlinePlus

Schematic presentation.
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Figure 2: Schematic presentation.

Mentions: We dissected an upper limb of a 76-year-old male cadaver, for educational purposes. First, we exposed and then removed the fascia of the forearm and palm. The ulnar nerve and its dorsal ramus were exposed after reflecting the flexor carpi ulnaris tendon medially, by removing the flexor retinaculum and transecting the roof of Guyon's canal. The ulnar artery was removed in order to obtain a better view of the course of the ulnar nerve in this region. After careful dissection in the wrist area, we found a thin nerve branch, originating from the dorsal ulnar nerve branch approximately 3 cm proximal to the ulnar styloid process. This nerve branch, called Kaplan anastomosis, was parallel to the ulnar nerve. This nerve branch gave off many thin branches along its course for the synovial membrane of the joint, the abductor of the fifth finger and the skin of the area. The nerve branch then passed through Guyon's canal close to the pisiform bone and finally merged with the trunk of the ulnar nerve just before its division into the superficial and deep rami (Figures 1 and 2).


Kaplan anastomosis of the ulnar nerve: a case report.

Paraskevas G, Ch Gekas C, Tzaveas A, Spyridakis I, Stoltidou A, Ph Tsitsopoulos P - J Med Case Rep (2008)

Schematic presentation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2365964&req=5

Figure 2: Schematic presentation.
Mentions: We dissected an upper limb of a 76-year-old male cadaver, for educational purposes. First, we exposed and then removed the fascia of the forearm and palm. The ulnar nerve and its dorsal ramus were exposed after reflecting the flexor carpi ulnaris tendon medially, by removing the flexor retinaculum and transecting the roof of Guyon's canal. The ulnar artery was removed in order to obtain a better view of the course of the ulnar nerve in this region. After careful dissection in the wrist area, we found a thin nerve branch, originating from the dorsal ulnar nerve branch approximately 3 cm proximal to the ulnar styloid process. This nerve branch, called Kaplan anastomosis, was parallel to the ulnar nerve. This nerve branch gave off many thin branches along its course for the synovial membrane of the joint, the abductor of the fifth finger and the skin of the area. The nerve branch then passed through Guyon's canal close to the pisiform bone and finally merged with the trunk of the ulnar nerve just before its division into the superficial and deep rami (Figures 1 and 2).

Bottom Line: The sensory innervation of the hand is usually unvarying and anomalies in this area are uncommon.We report the case of a rare ulnar nerve branch called a Kaplan anastomosis, which anastomosed the dorsal cutaneous branch with the ulnar nerve prior to its bifurcation into the superficial and deep ramus.Many authors have reported unusual ulnar nerve branches and knowledge of these anatomical variations is important for the interpretation of pain and sensory loss in the area sustained during injuries or surgical procedures.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Anatomy, Medical Faculty, Aristotle University of Thessaloniki, Thessaloniki, Greece. g_paraskevas@yahoo.gr

ABSTRACT

Introduction: The sensory innervation of the hand is usually unvarying and anomalies in this area are uncommon.

Case presentation: We report the case of a rare ulnar nerve branch called a Kaplan anastomosis, which anastomosed the dorsal cutaneous branch with the ulnar nerve prior to its bifurcation into the superficial and deep ramus.

Conclusion: Many authors have reported unusual ulnar nerve branches and knowledge of these anatomical variations is important for the interpretation of pain and sensory loss in the area sustained during injuries or surgical procedures. Our finding is the fourth case of a Kaplan anastomosis to be described in the literature.

No MeSH data available.


Related in: MedlinePlus