Sunderland's median nerve fascicular anatomy revisited by ultrasound

The internal anatomy of the upper-limb nerves was investigated with microdissection by the seminal work of Sunderland.1 More recent autopsy studies further explored the fascicular anatomy of the median nerve (MN) and confirmed a radial-to-ulnar sensory and motor arrangement of nerve fascicles at the wrist.2 ,3 We report two patients with partial MN damage, in whom sensory neurography and ultrasound (US) documented asymmetrical involvement of the nerve involving its ulnar and radial sectors, respectively. Patient 1 was a 22-year-old man with a penetrating lesion of the wrist because of a glass fragment. He reported sensory loss and paraesthesia involving the ulnar side of the index, middle and radial side of the ring finger with no motor symptoms. Median sensory neurography showed markedly reduced ring finger sensory nerve action potential (SNAP), absent middle finger SNAP and slightly reduced, but still in …