Martin–Gruber anastomosis
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A Martin–Gruber anastomosis (MGA) is a connection from the median nerve to the ulnar nerve in the forearm. An anastomosis occurs when two structures that normally are not connected have a connection. In this case the connection is a nerve. The Martin–Gruber anastomosis is most common anastomosis that occurs between these two nerves.[1] This connection carries motor axons which innervate some of the usually ulnar nerve innervated intrinsic muscles.
This inconstant pattern of connection can serve as explanation for a difficult or challenging differential diagnosis.[2] In one study,[3] the MGA was found in 22.9% of cadaver specimens, while another found the incidence at ~11%.[4] This relatively high incidence demonstrates the necessity for healthcare specialists to factor the MGA into their diagnoses.
Types
[edit]There are six types of Martin-Gruber anastomoses.
Clinical significance
[edit]In the setting of proximal ulnar nerve injury, a Martin-Gruber anastomosis can prevent the complete paralysis of the intrinsic muscles of the hand.
History
[edit]The Martin–Gruber anastomosis is named after Swedish physician Roland Martin and Austrian anatomist Wenzel Gruber, who described it independently in 1763 and 1870 respectively.[5][6]
References
[edit]- ^ Erdem HR, Ergun S, Erturk C, Ozel S (June 2002). "Electrophysiological Evaluation of the Incidence of Martin-Gruber Anastomosis in Healthy Subjects". Yonsei Medical Journal. 43 (3): 291–5. doi:10.3349/ymj.2002.43.3.291. PMID 12089734.
- ^ Unver Dogan, Nadire (March 14, 2009). "The communications between the ulnar and median nerves in upper limb" (PDF). neuroanatomy.org. Retrieved 2012-09-01.
- ^ Rodriguez-Niedenführ M, Vazquez T, Parkin I, Logan B, Sañudo JR (March 2002). "Martin-Gruber anastomosis revisited". Clinical Anatomy. 15 (2): 129–34. doi:10.1002/ca.1107. PMID 11877791.
- ^ Kaur, et al. (Feb 2016). "Martin–Gruber Anastomosis- A Cadaveric Study in North Indian Population". Journal of Clinical and Diagnostic Research. 10 (2): AC09 – AC11. doi:10.7860/JCDR/2016/16447.7247. PMC 4800503. PMID 27042438.
- ^ Leibovic SJ, Hastings H (January 1992). "Martin-Gruber revisited". J Hand Surg Am. 17 (1): 47–53. doi:10.1016/0363-5023(92)90112-3. PMID 1538112.
- ^ Roy J, Henry BM, PĘkala PA, Vikse J, Saganiak K, Walocha JA, Tomaszewski KA (June 2016). "Median and ulnar nerve anastomoses in the upper limb: A meta-analysis". Muscle Nerve. 54 (1): 36–47. doi:10.1002/mus.24993. PMID 26599506.