Martin-Gruber communicating branch: anatomical and histological study

Shu, Huang; Chantelot, Christophe; Oberlin, C.; Alnot, J.Y.; Shao, Hui

doi:10.1007/s00276-999-0115-9

Cited by 46 publications

(57 citation statements)

References 8 publications

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“…An anomalous connection, commonly known as a MartinGruber anastomosis, may occur between the median and ulnar nerve in the forearm, resulting in varied patterns of innervation to the intrinsic muscles of the hand (14)(15)(16)(17)(18)(19)(20). The MartinGruber anastomosis is median to ulnar in nature (21).…”

Section: Martin-gruber and Marinacci Communicationsmentioning

confidence: 99%

Anatomical variations of the carpal tunnel structures

Mitchell¹,

Chesney²,

Seal³

et al. 2009

CAN J PLAST SURG

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Asurgeon's expert competency should include an appreciation of anatomical variations, particularly with respect to common surgical procedures. One such procedure where this is relevant to plastic surgeons is the carpal tunnel release. The carpal tunnel has been recognized as a site where multiple anatomical variations can occur. These variations can involve neural, vascular, tendinous and muscular structures. If these are unrecognized, there is a risk of iatrogenic injury to the involved structures leading to unfavourable surgical outcomes. The purpose of the present review is to highlight recognized anatomical variations within the carpal tunnel and, hopefully, to help practitioners perform safe surgery. The Carpal TunnelThe carpal tunnel is defined as the space deep to the transverse carpal ligament. The transverse carpal ligament extends ulnarly from the hook of hamate and the triquetrum to the scaphoid and the trapezium radially. The carpal tunnel is bordered posteriorly by the carpal bones. Within the carpal tunnel lie the median nerve and nine flexor tendons: the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons to the index, middle, ring and small fingers, as well as the flexor pollicis longus (FPL) tendon. A review of the literature identified variations in the structure within and around the carpal tunnel (Table 1). VariaTion in nerVe anaTomyhigh bifurcation of the median nerve In most subjects, the median nerve courses through the carpal tunnel as a single nerve, dividing to form the digital nerves distal to the transverse carpal ligament. Bifurcation of the median nerve proximal to the transverse carpal ligament is a relatively common anatomical variation present in 1% to 3.3% of individuals undergoing carpal tunnel release surgery (Figure 1) (1-3). High bifurcation of the median nerve can be an isolated finding (7) or it can be associated with a persistent median artery (4) or an accessory muscle belly of the long finger flexor superficialis (1,5,6). A case of a bifid median nerve wherein the radial-sided branch was located in its own compartment within the carpal tunnel has been identified by the senior author (AT) (Figure 2). To our knowledge, this is the first report of this variation. This additional compartment was also released with satisfactory outcome. There are many anatomical variations in and around the carpal tunnel that affect the nerves, tendons and arteries in this area. Awareness of these variations is important both during the clinical examination and during carpal tunnel release. The purpose of the present review is to highlight recognized anatomical variations within the carpal tunnel including variation in nerve anatomy, tendon anatomical variants, vascular anatomical variations and muscle anatomical variations.

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Section: Martin-gruber and Marinacci Communicationsmentioning

confidence: 99%

Anatomical variations of the carpal tunnel structures

Mitchell¹,

Chesney²,

Seal³

et al. 2009

CAN J PLAST SURG

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“…The mechanism of this partial thenar muscle preservation would be that the anastomotic nerve fibers that had crossed over from the median nerve to the ulnar nerve in the forearm ran unimpeded to the muscles of the thenar eminence so that their regarding the laterality of the anastomosis. Some studies report its right predominance (Nakashima et al [4]; Shu et al [14], Sarikcioglu et al [16], Felippe et al [20]), whereas some others reported left side dominance (Almeida et al [19]; Lee et al [17]). Kimura et al [7] reported a majority of bilateral cases while Taams [21] and Prates et al [10] did not find any significant differences between both sides as in our study.…”

Section: Discussionmentioning

confidence: 99%

An Anatomical Study of Median and Ulnar Nerve Communication in the Forearm

Chunder¹,

Sarkar²

2017

IJAR

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Background: Communications between nerves are relatively common, and individual variations in their anatomical organization have been described in various studies. Knowledge of the prevalence of such variations is necessary when establishing the diagnosis of neuropathies and surgical landmarks. This study has as purpose to report the incidence, type, topography of the presence of median and ulnar nerve communication in the forearm

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“…Чаще анастомоз встречается справа [5,[7][8][9], в 10-40 % случаев он бывает двусторонним [1,6,8]. Учитывая широкую распространенность анастомоза, он рассма-тривается как вариант развития, а не аномалия.…”

Section: анатомия и классификацияunclassified

“…Филогенетически анастомоз может рассматри-ваться как остатки общего вентрального нервного ствола, иннервирующего мышцы-сгибатели, присут-ствующего на ранних стадиях развития [1]. Факт того, что наличие анастомоза филогенетически обусловлено, подтверждают данные исследования Shu et al [9], от-мечавших его широкую распространенность у обезьян.…”

Section: анатомия и классификацияunclassified

Martin–gruber Anastomosis and Its Clinical Importance

Михайлюк¹

2015

Klinicist

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MARTIN-GRuBER ANASTOMOSIS AND ITS CLINICAL IMPORTANCE I. G. Mikhaylyuk Department of Nervous System Diseases with Medical Genetics and Neurosurgery, Yaroslavl State Medical University, Ministry of Health of Russia; 5 Revolyutsionnaya St., Yaroslavl, 150000, Russia The communication between the median and ulnar nerves on the forearm, known as the Martin-Gruber anastomosis, is widespread in the general population. Despite the fact that this connection is described by anatomists in XVIII century, its importance has only recently been appreciated because of the widespread of the electrophysiological techniques in clinical practies. However, in the Russian literature aspects of its practical value described so far is not enough. This article deals with the prevalence of the anastomosis, its anatomical and electrophysiological classification, options innervation of muscles of the hand, is carried out through him, described electrophysiological methods and criteria for its diagnosis, including the collision technique, in healthy subjects and patients with lesions of the median and ulnar nerves

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Martin-Gruber communicating branch: anatomical and histological study

Cited by 46 publications

References 8 publications

Anatomical variations of the carpal tunnel structures

Anatomical variations of the carpal tunnel structures

An Anatomical Study of Median and Ulnar Nerve Communication in the Forearm

Martin–gruber Anastomosis and Its Clinical Importance

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