{"id":3138,"date":"2026-03-05T07:08:56","date_gmt":"2026-03-05T07:08:56","guid":{"rendered":"https:\/\/www.ijmhr.org\/IntJAnatRes\/?page_id=3138"},"modified":"2026-03-05T07:16:08","modified_gmt":"2026-03-05T07:16:08","slug":"ijar-2025-274","status":"publish","type":"page","link":"https:\/\/www.ijmhr.org\/IntJAnatRes\/ijar-2025-274","title":{"rendered":"IJAR.2025.274"},"content":{"rendered":"<div class=\"su-row\"><div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\"><div class=\"su-button-center\"><a href=\"https:\/\/www.ijmhr.org\/ijar.14.1\/IJAR.2025.274.pdf\" class=\"su-button su-button-style-default\" style=\"color:#FFFFFF;background-color:#6b0e00;border-color:#560c00;border-radius:5px;-moz-border-radius:5px;-webkit-border-radius:5px\" target=\"_self\"><span style=\"color:#FFFFFF;padding:6px 16px;font-size:13px;line-height:20px;border-color:#98574d;border-radius:5px;-moz-border-radius:5px;-webkit-border-radius:5px;text-shadow:none;-moz-text-shadow:none;-webkit-text-shadow:none\"><i class=\"sui sui-cloud-download\" style=\"font-size:13px;color:#FFFFFF\"><\/i> DOWNLOAD PDF<\/span><\/a><\/div><\/div><\/div> <div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\"><div class=\"su-button-center\"><a href=\"https:\/\/ijmhr.org\/ijar-vol-14-1.htm\" class=\"su-button su-button-style-default\" style=\"color:#FFFFFF;background-color:#6b0e00;border-color:#560c00;border-radius:5px;-moz-border-radius:5px;-webkit-border-radius:5px\" target=\"_self\"><span style=\"color:#FFFFFF;padding:6px 16px;font-size:13px;line-height:20px;border-color:#98574d;border-radius:5px;-moz-border-radius:5px;-webkit-border-radius:5px;text-shadow:none;-moz-text-shadow:none;-webkit-text-shadow:none\"><i class=\"sui sui-book\" style=\"font-size:13px;color:#FFFFFF\"><\/i> Table of Contents<\/span><\/a><\/div><\/div><\/div><\/div>\n<h3 style=\"text-align: justify;\"><strong>Type of Article:<\/strong>\u00a0 Review<\/h3>\n<h3 style=\"text-align: justify;\"><strong>Volume 14; Issue 1 (March<\/strong><strong> 2026)<\/strong><\/h3>\n<h3 style=\"text-align: justify;\"><strong>Page No.:<\/strong> 9434-9437<\/h3>\n<h3 style=\"text-align: justify;\"><strong>DOI:\u00a0<\/strong>https:\/\/dx.doi.org\/10.16965\/ijar.2025.274<\/h3>\n<h3 style=\"text-align: justify;\">The Deep Motor Branch of the Ulnar Nerve and Its Role in Hand Spasticity: A Narrative Review for Surgical Applications<\/h3>\n<p><strong>Sani Baimai *<sup>1<\/sup>,<\/strong> <strong>Tanisha Abrol <sup>2<\/sup>, Chutikan Kaensa <sup>3<\/sup>.<\/strong><\/p>\n<p style=\"text-align: justify;\"><sup>*1<\/sup> Assistant Professor, Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand, <strong>ORCiD:<\/strong> 0000-0001-7988-1397<\/p>\n<p style=\"text-align: justify;\"><sup>2<\/sup> Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.<\/p>\n<p style=\"text-align: justify;\"><sup>3<\/sup> Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.<\/p>\n<p style=\"text-align: justify;\"><strong>Corresponding author: <\/strong>Dr. Sani Baimai, M.D., Ph.D (Anatomy), Assistant Professor, Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. <strong>E-Mail: <\/strong><a href=\"mailto:sanibaimai@gmail.com\">sanibaimai@gmail.com<\/a><\/p>\n<p><strong>A<\/strong><strong>BSTRACT<\/strong><\/p>\n<p style=\"text-align: justify;\">The deep motor branch of the ulnar nerve (DMBUN) plays a critical role in intrinsic hand function and deformities related to spasticity. Traditionally described as a single motor trunk, recent anatomical studies demonstrate multiple branching patterns and gender-based differences that challenge classical descriptions. These findings have important implications for selective surgical procedures, particularly hyperselective neurectomy (HSN), which has emerged as a promising treatment for hand spasticity. Evidence from cadaveric mapping, case series, and clinical outcome reports suggests that HSN targeting the DMBUN can achieve durable tone reduction and functional improvement with minimal complications. Conversely, the DMBUN is also at risk of iatrogenic injury during carpal tunnel release, underscoring the importance of respecting anatomical landmarks. Although current outcomes are encouraging, the literature is limited by the use of small cohorts and the absence of randomized controlled trials. Future studies should prioritize patient-specific anatomical mapping and long-term prospective data. Integrating anatomical precision with selective surgical strategies offers the best opportunity to improve outcomes for patients with hand spasticity.<\/p>\n<p style=\"text-align: justify;\"><strong>KEYWORDS:<\/strong> Ulnar nerve, Deep motor branch, Hyperselective neurectomy, Hand spasticity, Anatomical variation, Carpal tunnel surgery.<\/p>\n<p style=\"text-align: justify;\"><strong>REFERENCES<\/strong><\/p>\n<p style=\"text-align: justify;\">[1]. Agur AMR, Lee MJ, Grant JCB. Grant&#8217;s Atlas of Anatomy. 12th ed. Philadelphia: Lippincott Williams &amp; Wilkins; 2019.<br \/>[2]. Netter FH. Atlas of Human Anatomy. 7th ed. Philadelphia: Elsevier; 2018.<br \/>[3]. Williams PL. Gray&#8217;s Anatomy: The Anatomical Basis of Medicine and Surgery. 39th ed. Edinburgh: Churchill Livingstone; 2005.<br \/>[4]. Bini N, Leclercq C. Anatomical study of the deep branch of the ulnar nerve and application to selective neurectomy. Surg Radiol Anat. 2020;42:253-8.<br \/>https:\/\/doi.org\/10.1007\/s00276-019-02380-y<br \/>PMid:31745617<br \/>[5]. Costa AL, et al. Topography of the deep branch of the ulnar nerve between genders: a cadaveric study. J Plast Surg Hand Surg. 2023;57:178-80.<br \/>https:\/\/doi.org\/10.1080\/2000656X.2022.2032103<br \/>PMid:35100518<br \/>[6]. Pautler DL, et al. Anatomical characterization and mapping of the distal ulnar nerve. Hand (N Y). 2024.<br \/>[7]. Siriwittayakorn W, et al. Anatomic study of the motor branch of the ulnar nerve in carpal tunnel surgery. J Hand Surg Asian Pac. 2023;28:187-91.<br \/>https:\/\/doi.org\/10.1142\/S2424835523500194<br \/>PMid:37120297<br \/>[8]. Gras M, Leclercq C. Hyperselective neurectomy for upper limb spasticity: long-term results. Hand Surg Rehabil. 2017;36:321-7.<br \/>https:\/\/doi.org\/10.1016\/j.hansur.2017.06.009<br \/>PMid:29033227<br \/>[9]. Leclercq C, et al. Hyperselective neurectomy for upper limb spasticity: a prospective study. J Hand Surg Eur Vol. 2021;46:708-16.<br \/>https:\/\/doi.org\/10.1177\/17531934211027499<br \/>PMid:34256619<br \/>[10]. Yong RJ, et al. Selective peripheral neurotomy for spasticity: a systematic review. Neurosurg Focus. 2018;45:E10.<br \/>[11]. Rhee PC. Surgical management of the spastic forearm, wrist, and hand. JBJS Rev. 2019;7:e5.<br \/>https:\/\/doi.org\/10.2106\/JBJS.RVW.18.00172<br \/>PMid:31343511<br \/>[12]. Gohritz A, Frid\u00e9n J. Upper limb surgery for spasticity after spinal cord injury. J Hand Surg Eur Vol. 2018;43:508-15.<br \/>https:\/\/doi.org\/10.1177\/1753193418758852<br \/>PMid:29490539<br \/>[13]. Blair WF, Percival KJ, Morecraft R. Distribution of the deep branch of the ulnar nerve in the hypothenar eminence. Clin Orthop Relat Res. 1988;229:294-301.<br \/>https:\/\/doi.org\/10.1097\/00003086-198804000-00041<br \/>[14]. Keenan MAE. Phenol neurolysis for upper limb spasticity. J Hand Surg Am. 1987;12:962-7.<br \/>https:\/\/doi.org\/10.1016\/S0363-5023(87)80059-X<br \/>PMid:3655233<br \/>[15]. Chang MC, Boudier-Rev\u00e9ret M. Ultrasound-guided alcohol injection to the deep branch of the ulnar nerve. J Med Ultrasound. 2021;29:207-8.<br \/>https:\/\/doi.org\/10.4103\/JMU.JMU_110_20<br \/>PMid:34729331 PMCid:PMC8515629<br \/>[16]. Sze RY, et al. Long-term outcomes of hyperselective neurectomy for spasticity. Hand Surg Rehabil. 2025;44:25-32.<br \/>[17]. Terrono AL, et al. Iatrogenic injury to the deep motor branch of the ulnar nerve during carpal tunnel release. J Hand Surg Am. 1993;18:516-23.<br \/>https:\/\/doi.org\/10.1016\/0363-5023(93)90399-N<br \/>PMid:8294738<br \/>[18]. Siriwittayakorn W, et al. Isolated motor branch injury during open carpal tunnel release: a case report. Cureus. 2023;15:e39717.<br \/>https:\/\/doi.org\/10.7759\/cureus.43601<br \/>PMid:37719604 PMCid:PMC10504059<br \/>[19]. Emamhadi M, et al. Hyperselective neurectomy of the flexor digitorum superficialis for finger spasticity. World Neurosurg. 2023;172:e342-9.<\/p>\n<p style=\"text-align: justify;\">\n\t\t\t <div class=\"promo1\" style=\"background-color:#f7f7f7; border-color: #6b0e00 #e8e6e6 #e8e6e6;\">\n             \t <span style=\"color: #800000;\"><strong>Cite this article:<\/strong><\/span> Sani Baimai, Tanisha Abrol, Chutikan Kaensa. The Deep Motor Branch of the Ulnar Nerve and Its Role in Hand Spasticity: A Narrative Review for Surgical Applications. Int J Anat Res 2026;14(1):9434-9437. <strong>DOI:\u00a0<\/strong>10.16965\/ijar.2025.274\u00a0 \n             <\/div>\t\n\t\t\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Type of Article:\u00a0 Review Volume 14; Issue 1 (March 2026) Page No.: 9434-9437 DOI:\u00a0https:\/\/dx.doi.org\/10.16965\/ijar.2025.274 The Deep Motor Branch of the Ulnar Nerve and Its Role in Hand Spasticity: A Narrative Review for Surgical Applications Sani Baimai *1, Tanisha Abrol 2, Chutikan Kaensa 3. *1 Assistant Professor, Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol<br \/><a class=\"moretag\" href=\"https:\/\/www.ijmhr.org\/IntJAnatRes\/ijar-2025-274\">+ Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/pages\/3138"}],"collection":[{"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/comments?post=3138"}],"version-history":[{"count":2,"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/pages\/3138\/revisions"}],"predecessor-version":[{"id":3144,"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/pages\/3138\/revisions\/3144"}],"wp:attachment":[{"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/media?parent=3138"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}