title: The vascularization of the median nerve in the distal forearm and its potential clinical importance.
abstract: OBJECTIVE
  The aims of this anatomical study were to identify any extrinsic blood supply to the median nerve in the distal forearm and to measure the tension required to approximate the severed nerve after and before dissecting it while maintaining its extrinsic blood supply.
  
  
  METHODS
  We injected the arterial system of 15 lightly embalmed forearms with red latex to define the vascular anatomy of the median nerve in the distal forearm. We measured the gap resulting from spontaneous retraction of the cut ends of the divided median nerve and the average tension needed to reapproximate the ends before and after resection of the attachments to the nerve on its superficial, deep, and ulnar aspects.
  
  
  RESULTS
  A constant branch to the median nerve arises from the radial artery approximately 5 cm proximal to the radial styloid process. The mean gap between the severed nerve ends was 1.2 cm (range, 0.9-1.7 cm). The mean tension required to coapt the nerve ends was 231 g force (range, 200-280 g), reducing to 89 g force (range, 60-110 g) when only its radial attachments, including this vessel, were preserved.
  
  
  CONCLUSIONS
  This cadaveric study suggests that it may be possible to advance the median nerve at the wrist while retaining the vascular connection and blood supply from the radial artery, and so maintain the vascularity of the nerve at the common site of nerve repair in the distal forearm.
  
  
  CONCLUSIONS
  This cadaveric study identifies constant arterial feeding branches from the radial artery to the median nerve in the distal forearm, and is a preliminary investigation into the possibility of advancing the median nerve for repair in the distal forearm while maintaining the continuity of this branch.
authors.affiliation: Christine M. Kleinert Institute for Hand and Microsurgery, University of Louisville School of Medicine, Louisville, KY, USA. t_giesen@hotmail.com
authors.forename: T
authors.initials: T
authors.lastname: Giesen
authors.forename: R D
authors.initials: RD
authors.lastname: Acland
authors.forename: S
authors.initials: S
authors.lastname: Thirkannad
authors.forename: D
authors.initials: D
authors.lastname: Elliot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D005542:Forearm / Q000098:blood supply* / Q000294:innervation*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000098:blood supply*; D008875:Middle Aged