A study to analyze the prevalence of nervous anastomosis (Martin–Gruber) in medical students
Journal Title: National Journal of Physiology, Pharmacy and Pharmacology - Year 2015, Vol 5, Issue 3
Abstract
Background: In nerve conduction laboratory, various types of case s are encountered. These are generally referred for electrophysiological investigation of the most common s yndromes such as carpel tunnel syndrome where there is partial or total sparing of the thenar muscles from the effect of compression of the ir nerve supply. So for the assessment of traumatic and entrapment lesions of media n and ulnar nerves, the knowledge of these anastomosis is important. Aims and Objectives: The purpose of this study was to assess t he prevalence of this anastomosis in healthy individuals, to draw attention of clin icians or surgeons from neurophysiology fi eld to this anastomosis, and to avoid misinterpretations of differe nt studies of needle electromyograph y and other nerve conduction studies. Materials and Methods: A total of 150 healthy volunteers were sel ected from the medica l students aged 17 – 30 years. Surface recording electrodes were placed on the hand abd uctor pollicis brevis, abductor digiti minimi, and the fi rst dorsal interossei (FDI) of each subject. Using surface elect rodes, we percutaneously stimulated the median and ulnar nerves at the wrist and the elbow. Rectangular pulses o f0.2msdurationwereusedandthestimulusstrengthwas supramaximal. Compound muscle action potential (CMAP) w as recorded. CMAP from the FDI, hypothenar, and thenar muscles larger (at least 1.0 mV) on median nerve stimulat ion at the elbow than at the wrist and that from one or more of these sites larger (at least 1.0 mV) on stimulation of u lnarnerveatthewristthanattheelbowwereacceptedas indicators of the presence of the MGA. Analysis was carried ou t using Statistical Package fo r Social Sciences, version 10.0. P -value o 0.05 was considered as statistically signi fi cant. Results: The type of anastomosis frequently observed was type II, which was observed in 12 subjects; type I was observed in 3; type I + II was observed in 2; and type III was observed in 1 subject. Conclusion: Because of its high incidence and differen t electrodiagnostic considerations, MGAshouldbeconsideredtobeofgreatclinicalsigni fi cance for correct diagnosis and for planning appropriate therapy in peripheral lesions of median and ulnar nerves
Authors and Affiliations
Nilesh N Kate, Chandrika G Teli, Ratnesh Gajbhiye, Kondam Ambareesha, M Suresh
Keywords
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- EP ID EP112457
- DOI http://dx.doi.org/10.5455/njppp.2015.5.1207201414
- Views 53
- Downloads 0
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