# A Rare Anatomical Variant Dual Radial Digital Nerves in the Right Ring Finger: Consideration in Hand Dissection

## TL;DR

A rare case of dual radial digital nerves in a patient's right ring finger highlights the need for careful dissection during hand surgeries.

## Contribution

Reports a rare anatomical variant of dual radial digital nerves in the ring finger.

## Key findings

- Two distinct radial digital nerves were identified during surgery in the right ring finger.
- The same anatomical variant was confirmed in the contralateral ring finger during a subsequent procedure.
- This variant raises concerns about percutaneous procedures near the metacarpophalangeal joint.

## Abstract

Digital nerve anatomy in the fingers is considered a predictable pattern of a single radial and ulnar neurovascular bundle, allowing for often safe midline dissection. In complicated cases, such as Dupuytren contracture or trauma, knowledge of digital nerve anatomy is paramount for safe dissection. The patient was a 68-year-old man with bilateral ring finger Dupuytren contractures. On the right hand, he had a 40° flexion contracture of the ring finger and underwent a palmar fasciectomy. Two distinct radial digital nerves were identified intraoperatively, with one branch in the traditional radial aspect of the digit, and a second branch centrally overlying the flexor tendons. This finding was later corroborated on the contralateral ring finger when he underwent subsequent palmar fasciectomy. Dual radial digital nerves are an uncommon anatomical variant that underscores the importance of careful neurovascular dissection. This case also raises concerns about percutaneous procedures distal to the metacarpophalangeal joint crease.