Clinical repercussions of Martin-Gruber anastomosis: anatomical study

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• 作者：Cristina Schmitt Cavalheiro^a ; ^{cristina_schmitt@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Mauro Razuk Filho^a ; Gabriel Pedro^a ; Maur&iacute ; cio Ferreira Caetano^b ; Luiz Angelo Vieira^a ; Edie Benedito Caetano^a
• 关键词：Arteriovenous anastomosis/anatomy & histology ; Median nerve ; Ulnar nerve
• 刊名：Revista Brasileira de Ortopedia (English Edition)
• 出版年：2016
• 出版时间：March-April 2016
• 年：2016
• 卷：51
• 期：2
• 页码：214-223
• 全文大小：3134 K

文摘

The main objective of this study was to describe Martin-Gruber anastomosis anatomically and to recognize its clinical repercussions.

Method

100 forearms of 50 adult cadavers were dissected in an anatomy laboratory. The dissection was performed by means of a midline incision along the entire forearm and the lower third of the upper arm. Two flaps including skin and subcutaneous tissue were folded back on the radial and ulnar sides, respectively.

Results

Nerve communication between the median and ulnar nerves in the forearm (Martin-Gruber anastomosis) was found in 27 forearms. The anastomosis was classified into six types: type I: anastomosis between the anterior interosseous nerve and the ulnar nerve (n = 9); type II: anastomosis between the anterior interosseous nerve and the ulnar nerve at two points (double anastomosis) (n = 2); type III: anastomosis between the median nerve and the ulnar nerve (n = 4); type IV: anastomosis between branches of the median nerve and ulnar nerve heading toward the flexor digitorum profundus muscle of the fingers; these fascicles form a loop with distal convexity (n = 5); type V: intramuscular anastomosis (n = 5); and type VI: anastomosis between a branch of the median nerve to the flexor digitorum superficialis muscle and the ulnar nerve (n = 2).

Conclusion

Knowledge of the anatomical variations relating to the innervation of the hand has great importance, especially with regard to physical examination, diagnosis, prognosis and surgical treatment. If these variations are not given due regard, errors and other consequences will be inevitable.