Martin-Gruber Anastomosis

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

There are six types of Martin-Gruber anastomoses.

Clinical Significance

In the setting of proximal ulnar nerve injury, a Martin-Gruber anastomosis can prevent the complete paralysis of the intrinsic muscles of the hand.

References
  1. 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.
  2. Unver Dogan, Nadire (March 14, 2009). "The communications between the ulnar and median nerves in upper limb" (PDF). neuroanatomy.org. Retrieved 2012-09-01.
  3. 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.
  4. 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.
  • Standring, Susan (2008). Gray's Anatomy 40th ed. Elsevier. p. 854. ISBN 978-0443066849.
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