Internal topography of major nerves of the forearm and hand: a current view

Fresh cadaver nerves were examined by serial cross-sections and microdissection with the operating microscope. The findings are compared with those of previous authors, primarily Sydney Sunderland. Our study confirms and amplifies Sunderland's findings: although it is true that funicular prexus formation and interchange takes place in the nerves of the human forearm, these connections are not of such a degree as to preclude operative procedures such as intraneural neurolysis, fascicular nerve repair, and interfascicular nerve grafting. Individual branches and bundles can be identified and traced within the main nerve trunk for considerable distances without significant trauma to conducting fibers. This arrangement lends itself to the application of modern microneurosurgical techniques. Clinical applications of these findings in the repair, lysis, and grafting of the major nerves of the forearm are described. The possibility of using such branches as the dorsal cutaneous branch of the ulnar nerve(if irreparably damaged) as a donor nerve for grafting is noted.