Shaw k, wido d, smith m, miller m

Abstract accepted at American Association of Neuromuscular and Electrodiagnostic Medicine 2024

Electrodiagnostic studies and diagnostic ultrasound evaluation are vital tools for the management of CTS. Aberrant anatomy is an important consideration for surgical disposition. Berrettini anastomosis is an interneural communication between common palmar digital sensory branches from the median and ulnar nerves. Here, we report a unique case of a patient with moderate carpal tunnel syndrome and concomitant Berrettini anastomosis, highlighting preoperative value of ultrasound in the EDX clinic in avoidance of iatrogenic injury. 

Ultrasound is an important adjunct to EDX in the preoperative stage of carpal tunnel syndrome management. Identification of aberrant anatomy via ultrasound has the potential to minimize complications from carpal tunnel release (CTR). In this case, a Berrettini anastamosis was identified and rather than proceed with ultrasound-guided CTR, the patient was referred to Orthopedics for open CTR.