Martin Gruber Anastomosis: Difference between revisions
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== Introduction == | == Introduction == | ||
Anomalous means deviated from normal / routine. Anomalous innervations are routinely a normal occurrence. But if these are not recognised, they may be mistaken for technical pitfall or an actual pathology which may not be present <ref name=":0">Aziz Saba EK. Electrophysiological study of Martin—Gruber anastomosis in a sample of Egyptians. Egyptian Rheumatology and Rehabilitation. 2017 Oct;44:153-8.</ref> Nerve communication between the median and ulnar nerves in the forearm, is known as Martin-Gruber anastomosis. This implies that nerve fascicles from Median nerve transfers to Ulnar nerve<ref>Cavalheiro CS, Razuk Filho M, Pedro G, Caetano MF, Vieira LA, Caetano EB. Clinical repercussions of Martin-Gruber anastomosis: anatomical study. Revista Brasileira de Ortopedia. 2016 Mar;51:214-23.</ref> | Anomalous means deviated from normal / routine. Anomalous innervations are routinely a normal occurrence. But if these are not recognised, they may be mistaken for technical pitfall or an actual pathology which may not be present <ref name=":0">Aziz Saba EK. Electrophysiological study of Martin—Gruber anastomosis in a sample of Egyptians. Egyptian Rheumatology and Rehabilitation. 2017 Oct;44:153-8.</ref> Nerve communication between the median and ulnar nerves in the forearm, is known as Martin-Gruber anastomosis. This implies that nerve fascicles from Median nerve transfers to Ulnar nerve<ref>Cavalheiro CS, Razuk Filho M, Pedro G, Caetano MF, Vieira LA, Caetano EB. Clinical repercussions of Martin-Gruber anastomosis: anatomical study. Revista Brasileira de Ortopedia. 2016 Mar;51:214-23.</ref> | ||
The prevalence of Martin Gruber Anastomosis is between 3.3 to 40% of population <ref name=":0" />with a prevalence of 11.6 % in Indian population <ref>Kaur N, Singla RK, Kullar JS. Martin–Gruber Anastomosis-A cadaveric study in north indian population. Journal of Clinical and Diagnostic Research: JCDR. 2016 Feb;10(2):AC09.</ref> | The prevalence of Martin Gruber Anastomosis (MGA) is between 3.3 to 40% of population <ref name=":0" />with a prevalence of 11.6 % in Indian population <ref>Kaur N, Singla RK, Kullar JS. Martin–Gruber Anastomosis-A cadaveric study in north indian population. Journal of Clinical and Diagnostic Research: JCDR. 2016 Feb;10(2):AC09.</ref>Median to Ulnar nerve communication was first described by Martin in 1763 <ref>Martin R. Tal om nervers allmänna egenskaper i människans kropp.</ref>who proposed the possibility of such a communication. This finding was finally confirmed after 100 years by Gruber in in 1870 <ref>Gruber W. Ueber die verbindung des nervus medianus mit dem nervus ulnaris am unterarme des menshen und der saugethiere. Arch Anat Phisiol. 1870;37:501.</ref> | ||
== | == Normal Innervation Pattern of Hand == | ||
{| class="wikitable" | |||
|+Standard innervation Pattern of muscles of hand as described in text books. | |||
!Median Nerve | |||
!Ulnar Nerve | |||
|- | |||
|Abductor Pollicis Brevis | |||
|Abductor Digiti Minimi | |||
|- | |||
|Opponens Pollicis Brevis | |||
|Flexor Digiti Minimi | |||
|- | |||
|Flexor Pollicis Brevis | |||
|Opponens Digiti Minimi | |||
|- | |||
|1st and 2nd Lumbrical | |||
|3rd and 4th Lumbrical | |||
|- | |||
| | |||
|Dorsal and Palmar Interossei | |||
|- | |||
| | |||
|Deep Head of Flexor Pollices Brevis | |||
|- | |||
| | |||
|Adductor Pollices | |||
|} | |||
Studies suggest that this standard pattern is seen in 33% of cases<ref>Rowntree T. Anomalous innervation of the hand muscles. The Journal of Bone and Joint Surgery. British volume. 1949 Nov;31(4):505-10.</ref> | |||
== Sub Heading 3 == | == Sub Heading 3 == |
Revision as of 16:36, 27 January 2024
Original Editor - Nehal Shah
Top Contributors - Nehal Shah and Ewa Jaraczewska
Introduction[edit | edit source]
Anomalous means deviated from normal / routine. Anomalous innervations are routinely a normal occurrence. But if these are not recognised, they may be mistaken for technical pitfall or an actual pathology which may not be present [1] Nerve communication between the median and ulnar nerves in the forearm, is known as Martin-Gruber anastomosis. This implies that nerve fascicles from Median nerve transfers to Ulnar nerve[2]
The prevalence of Martin Gruber Anastomosis (MGA) is between 3.3 to 40% of population [1]with a prevalence of 11.6 % in Indian population [3]Median to Ulnar nerve communication was first described by Martin in 1763 [4]who proposed the possibility of such a communication. This finding was finally confirmed after 100 years by Gruber in in 1870 [5]
Normal Innervation Pattern of Hand[edit | edit source]
Median Nerve | Ulnar Nerve |
---|---|
Abductor Pollicis Brevis | Abductor Digiti Minimi |
Opponens Pollicis Brevis | Flexor Digiti Minimi |
Flexor Pollicis Brevis | Opponens Digiti Minimi |
1st and 2nd Lumbrical | 3rd and 4th Lumbrical |
Dorsal and Palmar Interossei | |
Deep Head of Flexor Pollices Brevis | |
Adductor Pollices |
Studies suggest that this standard pattern is seen in 33% of cases[6]
Sub Heading 3[edit | edit source]
Resources[edit | edit source]
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References[edit | edit source]
- ↑ 1.0 1.1 Aziz Saba EK. Electrophysiological study of Martin—Gruber anastomosis in a sample of Egyptians. Egyptian Rheumatology and Rehabilitation. 2017 Oct;44:153-8.
- ↑ Cavalheiro CS, Razuk Filho M, Pedro G, Caetano MF, Vieira LA, Caetano EB. Clinical repercussions of Martin-Gruber anastomosis: anatomical study. Revista Brasileira de Ortopedia. 2016 Mar;51:214-23.
- ↑ Kaur N, Singla RK, Kullar JS. Martin–Gruber Anastomosis-A cadaveric study in north indian population. Journal of Clinical and Diagnostic Research: JCDR. 2016 Feb;10(2):AC09.
- ↑ Martin R. Tal om nervers allmänna egenskaper i människans kropp.
- ↑ Gruber W. Ueber die verbindung des nervus medianus mit dem nervus ulnaris am unterarme des menshen und der saugethiere. Arch Anat Phisiol. 1870;37:501.
- ↑ Rowntree T. Anomalous innervation of the hand muscles. The Journal of Bone and Joint Surgery. British volume. 1949 Nov;31(4):505-10.