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Innervation of digital joints: an anatomical overview.

S Gandolfi1, I Auquit-Auckbur1, B Chaput2

  • 1Department of Plastic, Reconstructive and Hand Surgery, Rouen University Hospital, Rouen, France.

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|May 6, 2021
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Summary

This study details the nerve branches innervating finger joints, crucial for understanding surgical denervation. Identifying these articular nerve pathways is key for effective pain relief in conditions affecting the digital joints.

Keywords:
AnatomyDenervationDigitHandInterphalangealJointMetacarpophalangealNerve

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Area of Science:

  • Anatomy
  • Surgical Anatomy
  • Neuroanatomy

Background:

  • The innervation patterns of digital joints are complex.
  • Understanding these anatomical relationships is vital for surgical procedures like denervation.
  • Previous studies have not fully elucidated the specific articular nerve branches.

Purpose of the Study:

  • To meticulously map the articular nerve branches supplying various digital joints.
  • To determine the feasibility of selective and efficient denervation of digital joints for pain management.
  • To provide detailed anatomical data for surgical planning.

Main Methods:

  • Dissection of ten hands, examining distal interphalangeal (DIP), proximal interphalangeal (PIP), metacarpophalangeal (MCP), thumb interphalangeal (IP), and trapezo-metacarpophalangeal (TMC) joints.
  • Detailed analysis under magnification, recording nerve branch origin, course, number, and caliber.
  • Systematic collection of data on articular innervation for each joint type.

Main Results:

  • Over 118 branches innervated DIP joints, primarily from palmar digital nerves.
  • PIPs received 226 branches, with 90.3% originating from palmar digital nerves.
  • MCP joints showed mixed innervation (palmar, dorsal, ulnar nerve), and TMC joints were consistently innervated by the radial nerve's sensory branch.

Conclusions:

  • Finger joints, except MCP and TMC, are mainly innervated by digital nerve branches.
  • Effective digital joint denervation requires precise knowledge of articular nerve localization and origin.
  • This anatomical understanding is critical for planning selective surgical approaches for pain relief.