Ulnar nerve component to innervation of thumb carpometacarpal joint.

Roberto Miki, Check C. Kam, Elisabeth R. Gennis, Jodie A. Barkin, Ryan U. Riel, Philip G. Robinson, Patrick Owens

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Thumb carpometacarpal (CMC) joint arthritis is one of the most common problems addressed by hand surgeons. The gold standard of treatment for thumb CMC joint arthritis is trapeziectomy, ligament reconstruction and tendon interposition. Denervation of the thumb CMC joint is not currently used to treat arthritis in this joint due to the failure of the procedure to yield significant symptomatic relief. The failure of denervation is puzzling, given that past anatomic studies show the radial nerve is the major innervation of the thumb CMC joint with the lateral antebrachial nerve and the median nerve also innervating this joint. Although no anatomic study has ever shown that the ulnar nerve innervates the CMC joint, due to both the failure of denervation and the success of arthroscopic thermal ablation, we suspect that previous anatomic studies may have overlooked innervation of the thumb CMC joint via the ulnar nerve. We dissected 19 formalin-preserved cadaveric hand-to-mid-forearm specimens. The radial, median and ulnar nerves were identified in the proximal forearm and then followed distally. Any branch heading toward the radial side of the hand were followed to see if they innervated the thumb CMC joint. Eleven specimens (58%) had superficial radial nerve innervation to the thumb CMC joint. Nine specimens (47%) had median nerve innervation from the motor branch. Nine specimens (47%) had ulnar nerve innervation from the motor branch. We believe this is the first study to demonstrate that the ulnar nerve innervates the thumb CMC joint This finding may explain the poor results seen in earlier attempts at denervation of the thumb CMC, but the more favorable results with techniques such as arthroscopy with thermal ablation.

Original languageEnglish
Pages (from-to)225-230
Number of pages6
JournalThe Iowa orthopaedic journal
Volume31
StatePublished - Dec 1 2011
Externally publishedYes

Fingerprint

Carpometacarpal Joints
Ulnar Nerve
Thumb
Denervation
Radial Nerve
Median Nerve
Arthritis
Hand
Forearm
Hot Temperature
Joints
Arthroscopy
Ligaments
Tendons
Formaldehyde

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Miki, R., Kam, C. C., Gennis, E. R., Barkin, J. A., Riel, R. U., Robinson, P. G., & Owens, P. (2011). Ulnar nerve component to innervation of thumb carpometacarpal joint. The Iowa orthopaedic journal, 31, 225-230.

Ulnar nerve component to innervation of thumb carpometacarpal joint. / Miki, Roberto; Kam, Check C.; Gennis, Elisabeth R.; Barkin, Jodie A.; Riel, Ryan U.; Robinson, Philip G.; Owens, Patrick.

In: The Iowa orthopaedic journal, Vol. 31, 01.12.2011, p. 225-230.

Research output: Contribution to journalArticle

Miki, R, Kam, CC, Gennis, ER, Barkin, JA, Riel, RU, Robinson, PG & Owens, P 2011, 'Ulnar nerve component to innervation of thumb carpometacarpal joint.', The Iowa orthopaedic journal, vol. 31, pp. 225-230.
Miki R, Kam CC, Gennis ER, Barkin JA, Riel RU, Robinson PG et al. Ulnar nerve component to innervation of thumb carpometacarpal joint. The Iowa orthopaedic journal. 2011 Dec 1;31:225-230.
Miki, Roberto ; Kam, Check C. ; Gennis, Elisabeth R. ; Barkin, Jodie A. ; Riel, Ryan U. ; Robinson, Philip G. ; Owens, Patrick. / Ulnar nerve component to innervation of thumb carpometacarpal joint. In: The Iowa orthopaedic journal. 2011 ; Vol. 31. pp. 225-230.
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