2014, Number 2
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Cir Plast 2014; 24 (2)
Topographic imaging of the anastomosis between median and ulnar nerves at forearm and hand
Rojas RL, Nieto RLE, Sepúlveda C
Language: Spanish
References: 21
Page: 82-87
PDF size: 323.71 Kb.
ABSTRACT
146 upper limbs were dissected in the Institute of Legal Medicine in Bogotá, Colombia. The corresponding photographic record for analysis was made. These were taken as reference points, the inter-epicondyle line, inter-styloid line, Kaplan cardinal line and proximal flexor crease of the first finger. We found the Martin-Gruber anastomosis in a 56.5 Marinacci in a 6.5%, the %, the Berrettini by 90% and the Riche-Cannieu in 88% of cases. Martin Gruber and Marinacci anastomoses were found bilaterally in 97%, and palmar anastomoses in 100% of cases were found on a bilateral basis. Both the point of origin and the Union of Martin-Gruber and Marinacci anastomoses were measured from the inter-epicondyle line, finding an average of 77 mm for the first and 74 mm for the second. Riche-Cannieu anastomosis to the average measure of 38 mm of line inter-styloid; 12 mm of the cardinal line of Kaplan and 25 mm from the flexor crease proximal of the first finger. For the anastomosis of Berretinni, its point of origin was to measure average 13 mm of the cardinal line of Kaplan and 32 mm in the inter-styloid line, while their point of union was 31 mm and 50 mm. We conclude that the anastomosis between the median nerve and ulnar are constant and findings can serve for other clinical applications.
REFERENCES
Rojas L, Herrera M. Anastomosis entre nervio mediano y cubital en antebrazo y palma de mano. Estudio anatómico en población colombiana. Rev Col Cir Plast Reconstr. 2011; 17: 29-36.
Rojas L, Mardach O, Nieto L. Inervación Tenar Dual: Anastomosis de Riche-Cannieu. Rev Col Cir Plast Reconstr. 2013; 19: 39-45.
Polatsch D, Melone CP Jr, Beldner S, Incorvaia A. Ulnar nerve anatomy. Hand Clin. 2007; 23: 283-289.
Rodriguez-Niedenführ M, Vazquez T, Ferreira B, Parkin I, Nearn L, Sañudo JR. Intramuscular Martin-Gruber anastomosis. Clin Anat. 2002; 15: 135-138.
Uchida Y, Sugioka Y. Electrodiagnosis of Martin-Gruber connection and its clinical importance in peripheral nerve surgery. J Hand Surg Am. 1992; 17: 54-59.
Leibovic SJ, Hastings H II: Martin-Gruber revisited. J Hand Surg Am. 1992; 17: 47-53.
Sarikcioglu L, Demirel BM. Martin-Gruber and Marinacci communications anatomic or physiologic consideration. J Hist Neurosci. 2006; 15: 99-101.
Marinacci AA. Diagnosis of “all median hand”. Electromyography. 1964; 4: 85-91.
Riche P. Le nerf cubital et les muscles de l’éminence thénar. Bull Mem Soc Anat Paris. 1897; 5: 251-252.
Cannieu A. Recherches sur l’innervation de l’éminence thénar par le cubital. J Med Bordeaux. 1896; 26: 377-379.
Bölükbasi O, Turgut M, Akyol A: Ulnar to median nerve anastomosis in the palm (Riche-Cannieu anastomosis). Neurosurg Rev. 1999; 22: 138-139.
Harness D, Sekeles E. The double anastomotic innervation of thenar muscles. J Anat. 1977; 109: 461-466.
Stancić MF, Mićović V, Potocnjak M: The anatomy of the Berrettini branch: implications for carpal tunnel release. J Neurosurg. 1999; 91: 1027-1030.
Dogan NU, Uysal II, Seker M. The communications between the ulnar and median nerves in upper limb. Neuroanatomy. 2009; 8: 15-19.
Kazakos K, Smyrnis A, Xarchas K, Dimitrakopoulou A, Verettas DA. Anastomosis between the median and ulnar nerve in the forearm. An anatomic study and literature review. Acta Orthop Belga. 2005; 71: 29-35.
Don Griot JP, Van Kooten O, Zuidam JM, Prosé LP, Hage JJ. Internal anatomy of the communicating branch between the ulnar and median nerves in the hand and its relevance to volar digital sensibility. J Hand Surg Am. 2002; 27: 143-146.
Dell PC, Sforzo CR. Ulnar intrinsic anatomy and dysfunction. J Hand Ther. 2005; 18: 198-207.
Meals RA, Shaner M. Variations in digital sensory patterns: a study of the ulnar nerve-median nerve palmar communicating branch. J Hand Surg Am. 1983; 8: 411-414.
Mannerfelt L. Studies on the hand in ulnar nerve paralysis: a clinical experimental investigation in normal and anomalous innervations. Acta Orthop Scand. 1966; 87: 23-142.
Kimura I, Ayyar DR, Lippmann SM. Electrophysiological verification of the ulnar to median nerve communications in the hand and forearm. Tohoku J Exp Med. 1983; 141: 269-274.
Rollins J, Meals RA. Recognition of acutely lacerated ulnar nerve median nerve palmar communicating branch. A case report. Clin Orthop Relat Res. 1985; 201: 91-93.