Renata Hodzic¹, Nermina Piric¹, Mirsad Hodzic², Biljana Kojic¹
¹Department of Neurology, University Clinical Centre, Tuzla, Bosnia and
Herzegovina; ²Department of Neurosurgery, University Clinical Centre, Tuzla,
Bosnia and Herzegovina
Background: Martin-Gruber anastomosis (MGA) is the well known
anostomosis that occur at the various levels between the median and ulnar
nerves. This anastomosis involves axons leaving either the main trunk of
median nerve or the anterior interosseous nerve, crossing through the
forearm to join the ulnar nerve. Knowledge of the incidence of this
anastomosis is necessary because MGA can cause confusion in the assesment of
nerve injuries and compressive neuropathies.
Aim: We aimed to assess the occurance and motor velocities of median
to ulnar nerve communication (MGA) in the forearm of Bosnian population by
electrophysiological examinations.
Material and Methods: One hundred and twenty forearms from a series
of 60 volunteers (25 females, 35 males, 23-78 years of age) were studied
electrophysiologically using needle recording electrodes. Volunteers with
peripheral neuropathies were excluded from the study. Needle recording
electrodes were places on the thenar and hypothenar muscles. The median and
ulnar nerves were stimulated supramaximally at the wrist and the elbow and
compound muscle action potentials (CMAPs) were recorded as well as motor
conduction velocities of median and ulnar nerves.
Results: Martin-Gruber anastomosis was found in 27 of 120 forearms;
it was bilateral in 7 and unilateral in 13, on the right side in nine and on
the left side in four forearms. There were no significant sexual differences
in the incidence. In MGA, when stimulating median nerve the respond of
abductor digiti minimi was registered in 11, whereas the respond of opponens
pollicis when stimulating ulnar nerve was registered in 18 subjects. This
finding was statistically significant.
Conclusion: With high incidence of MGA in Bosnian population, it is
necessary to be aware of the existance of this anomaly, location and its
possible presentation.
...................
Citation: Hodzic R, Piric N, Hodzic M, Kojic B. Electrophysiological
Evaluation of the Incidence of Martin-Gruber Anastomosis in Healthy Bosnian
Population. Maced J Med Sci. 2011 Dec 15; 4(4):376-379.
http://dx.doi.org/10.3889/MJMS.1957-5773.2011.0204.
Key words: Martin-Gruber anastomosis; electrophysiology; median
nerve; ulnar nerve; velocity.
Correspondence: Dr. Renata Hodzic. JZU UKC TUzla, Neurology, Trnovac
bb, Tuzla 75000, Bosnia and Herzegovina. Phone: +387 61 720624. E-Mail:
mirsad@bih.net.ba
Received: 08-Sep-2011; Revised: 03-Nov-2011; Accepted: 07-Nov-2011; Online
first: 26-Nov-2011
Copyright: © 2011 Hodzic R. This is an open access article
distributed under the terms of the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are credited.
Competing Interests: The authors have declared that no competing
interests exist.