Volume 48, Issue 4 pp. 539-544
Research Article

Prevalence of bifid median nerves and persistent median arteries and their association with carpal tunnel syndrome in a sample of latino poultry processors and other manual workers

Francis O. Walker MD

Corresponding Author

Francis O. Walker MD

Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, 27157-1078 USA

Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

Correspondence to: F.O. Walker; e-mail: [email protected]Search for more papers by this author
Michael S. Cartwright MS, MD

Michael S. Cartwright MS, MD

Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, 27157-1078 USA

Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

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Jill N. Blocker MS

Jill N. Blocker MS

Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

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Thomas A. Arcury PhD

Thomas A. Arcury PhD

Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

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Jung IM Suk MD

Jung IM Suk MD

Department of Neurology School of Medicine, Catholic University of Daegu, Daegu, South Korea

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Haiying Chen PhD

Haiying Chen PhD

Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

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Mark R. Schultz PhD

Mark R. Schultz PhD

Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina, USA

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Joseph G. Grzywacz PhD

Joseph G. Grzywacz PhD

Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

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Dana C. Mora MPH

Dana C. Mora MPH

Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

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Sara A. Quandt PhD

Sara A. Quandt PhD

Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

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First published: 30 January 2013
Citations: 53

This study was supported by the National Institute for Occupational Safety and Health (R01 OH9251).

ABSTRACT

Introduction

The prevalence of bifid median nerves and persistent median arteries, their co-occurrence, and their relationship to carpal tunnel syndrome (CTS) are only understood partially.

Methods

We screened 1026 wrists of 513 Latino manual laborers in North Carolina for bifid median nerves and persistent median arteries using electrodiagnosis and ultrasound.

Results

A total of 8.6% of wrists had a bifid median nerve, and 3.7% of wrists had a persistent median artery independent of subgroup ethnicity, age, gender, or type of work. An association with definite carpal tunnel syndrome was not found. The presence of either anatomic variant was associated with a high likelihood of co-occurrence of another variant in the same or the contralateral wrist.

Conclusions

The occurrence of median anatomic variants can be determined in field studies using ultrasound. Persistent median arteries and bifid median nerves tend to co-occur but do not put manual laborers at additional risk of developing CTS. Muscle Nerve 48: 539–544, 2013

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