Recurrent Branch of Median Nerve

Written by Kumail Jaffery

Last updated April 21, 2024 • 11 Revisions

The recurrent branch of median nerve (thenar muscular branch) is small motor branch of the median nerve in the hand.

It supplies the thenar muscles of the hand, which are associated with fine movements of the thumb.

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The recurrent branch of median nerve is a branch of the median nerve in the hand.

It typically arises distal to the flexor retinaculum, after which it curls proximally and laterally around the distal border of the ligament to supply the thenar muscles.

The origin of the recurrent branch is variable within the population, with two recognised aberrations:

  • Sub-ligamentous – arises within the carpal tunnel and courses underneath the flexor retinaculum before reaching the thenar muscles.
  • Trans-ligamentous – arises within the carpal tunnel and pieces the flexor retinaculum to reach the thenar muscles.

Fig 1
The recurrent branch of the median nerve typically arises distal to the carpal tunnel and supplies the thenar muscles of the hand.

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The recurrent branch of median nerve supplies muscles in the thenar eminence (mainly T1 but with some contribution from C8):

  • Flexor pollicis brevis – flexes the thumb.
  • Abductor pollicis brevis – abducts the thumb.
  • Opponens pollicis – opposes the thumb.

Fig 2
Palmar view of the thenar muscles.

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