A Unique Case of Split Median Nerve at the Wrist by a Branch of the Ulnar Artery

Anatomical variations of the median nerve at the wrist level have been detected during imaging, dissections and surgical operations. These include bifid median nerve and abnormal branching pattern of the median nerve. Splitting of the median nerve due to persistent median artery, accessory muscles and ulna artery also been reported in the literature. The knowledge of any such variation at the wrist is very important as injury to the nerve is common at this site and nerve decompression is commonly performed at the carpel tunnel. Based upon findings of his own study and the other published reports, Lanz classified the variations of the median nerve at the wrist into four groups in 1977. This report is on a special case where splitting of median nerve due to a branch of the ulna artery at the vicinity of the wrist and not included in the Lanz classification.