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Topic

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Dorsal digital nerve (hand)

The dorsal digital nerves of the hand are the terminal sensory branches supplying the dorsal skin of the fingers. These nerves arise from the superficial branch of the radial nerve (for the radial three and a half digits) and from the dorsal branch of the ulnar nerve (for the ulnar one and a half digits).

They provide cutaneous sensation to the dorsal aspects of the proximal and middle phalanges, with the distal dorsal fingertip instead supplied volarly by the palmar digital nerves.
Their superficial location makes them vulnerable to lacerations, crush injuries, traction injuries, and postsurgical neuromas.

Synonyms

  • Dorsal digital branches

  • Dorsal proper digital nerves

  • Dorsal digital sensory nerves

Origin, Course, and Distribution

Origin:

  • Radial side digits: from the superficial radial nerve

  • Ulnar side digits: from the dorsal branch of ulnar nerve

Course:

  • Run along the dorsolateral aspect of each finger, just beneath the skin and dorsal veins

  • Travel toward the proximal and middle phalanges

  • Cross the metacarpophalangeal joints superficially

Distribution:

  • Provide sensory innervation to:

    • Dorsal proximal phalanx

    • Dorsal middle phalanx

    • Dorsal lateral finger skin

Relations

  • Superficially: Skin and dorsal venous network of fingers

  • Deep: Extensor tendon expansions

  • Laterally: Dorsal digital arteries

  • Proximally: Extensor retinaculum region where they emerge superficially

Function

  • Convey light touch, pain, and temperature from the dorsal proximal and middle finger surfaces

  • Contribute to fine tactile discrimination along dorsolateral finger skin

  • Assist in protective reflex responses to dorsal stimuli

Clinical Significance

  • Frequently injured in lacerations, crush trauma, fingertip injuries, and dorsal hand cuts

  • Susceptible to traction neuropathy from repetitive extension activities

  • Can form painful neuromas after surgery or trauma

  • Important in digital nerve repair, flap planning, and dorsal finger incisions

MRI Appearance

T1-weighted images

  • Dorsal digital nerves appear as thin, low-to-intermediate signal intensity cords

  • Surrounded by bright subcutaneous fat, creating useful contrast

  • Extensor tendons: low signal, distinguishable from nerves

  • Bone marrow of phalanges: bright (fatty marrow)

T2-weighted images

  • Nerves remain intermediate-to-low signal, slightly brighter than tendons

  • Surrounding fat appears bright

  • Clear visualization within dorsal subcutaneous layer

STIR

  • Normal nerve: intermediate-to-dark signal intensity

  • Fat plane is suppressed, improving nerve conspicuity

  • Extensor tendons remain dark

MRI images

Dorsal digital nerve hand MRI axial image-img-00000-00000

MRI images

Dorsal digital nerve MRI coronal image-img-00000-00000