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Published on: April 18, 2020
Exploring Variations in Median Nerve Formation: Embryological Basis and a Pathway to Improved Clinical Outcomes
Sanghmithra Venkateswar1, Kalpana Ramachandran1
1Anatomy, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus
|May 7, 2026
Summary
Anatomical variations in median nerve formation are common, affecting 35% of upper limbs studied. These differences, particularly in males, are crucial for surgeons and neurologists to prevent injuries and interpret conditions.
Area of Science:
- Anatomy
- Morphology
- Clinical Anatomy
Background:
- The median nerve is a critical structure in the upper limb.
- Understanding its anatomical variations is vital for clinical practice.
Purpose of the Study:
- To investigate gross anatomical variability in median nerve formation.
- To evaluate clinical and surgical implications of these variations.
- To compare variations between sides and genders, and explore embryological basis.
Main Methods:
- Cadaveric investigation of 60 upper limbs (30 males, 30 females).
- Infraclavicular approach dissection to document median nerve root formation and relation to axillary artery.
- Statistical analysis using chi-square and Fisher's exact tests.
Main Results:
- Significant variations in median nerve formation observed in 35% of specimens.
- Classic two-root pattern in 65%; three-root contributions in 28.33% (predominantly males).
- Four-root (5%) and single-root (1.67%) formations also noted; one case showed absent musculocutaneous nerve.
Conclusions:
- Variations in median nerve formation are common and clinically significant.
- Heightened awareness is necessary for surgeons, anaesthesiologists, and neurologists.
- Knowledge of variations aids in preventing iatrogenic injuries and interpreting neurological presentations.
