Variations of median nerve in hand from surgical point of view

Introduction: The Median nerve or labourer's nerve has wide distribution up to wrist and palm of hand. The aim of this study is to find out the prevalence rates of anatomical variations of Median nerve in carpal tunnel, wrist, along with variations of the million dollar nerve of hand, the thenar recurrent branch. Materials & Methods: 50 upper limbs of 25 adult embalmed cadavers were dissected in West Bengal, during routine UG dissections for two academic sessions 2021-22 and 2022-23. All the variations of Median nerve including thenar recurrent nerve were noted. Results: In 98% cases two common digital nerves arose from medial division of Median Nerve and in 2% cases lateral common digital nerve arose from lateral division of Median Nerve. In 4% cases accessory Thenar recurrent nerves were present. Thenar recurrent nerve course was found Extraligamentous in 72% cases, Subligamentous in 20% cases and Transligamentous variety in 8% cases. Conclusion: During repair of traumatic injuries at hand, release of flexor retinaculum for carpal tunnel syndrome, surgeries involving the thenar muscles, awareness of anatomical variations of the Median nerve and its thenar recurrent branch is important for their preservation.