Anatomical study of the dorsal cutaneous branch of the ulnar nerve using ultrasound

Abstract

Objectives: To determine whether ultrasound allows precise assessment of the course and relations of the dorsal cutaneous branch of the ulnar nerve (DCBUN).

Methods: This work, initially undertaken in cadavers, was followed by high-resolution ultrasound study in 20 healthy adult volunteers (40 nerves) by two musculoskeletal radiologists in consensus. Location and course of the DCBUN and its relations to adjacent anatomical structures were analysed.

Results: The DCBUN was consistently identified along its entire course by ultrasound. Mean cross-sectional area of the nerve was 1.6 mm(2) (range 1.1-2.2). The level at which the DCBUN branches from the ulnar nerve was located a mean of 57 mm (range 40-80) proximal to the ulnar styloid process and 11 mm (range 7-15) radial to the medial border of the ulna. The DCBUN then crossed the medial border of the ulna a mean of 14 mm (range 6-25) proximal to the ulnar styloid process.

Conclusion: The DCBUN is clearly depicted by ultrasound. Precise mapping of its anatomical course could have significant clinical applications, such as preventing injury during surgery of the ulnar side of the wrist or helping in the diagnosis of chronic pain of the ulnar side of the hand.

Key points: • The dorsal cutaneous branch of the ulnar nerve (DCBUN) is often injured. • The DCBUN originates from the ulnar nerve in the distal third of the forearm. • It can be clearly depicted by ultrasound. • The level at which the DCBUN crosses the ulna is variable. • Precise mapping of its anatomical course could have significant clinical applications.