Annals of Rehabilitation Medicine

"Martin-Gruber anastomosis"

Case Report

Ulnar Neuropathy Around the Mid-Arm Combined with Martin-Gruber Anastomosis: Bong Joo Kim, Dong Hwee Kim; Ann Rehabil Med 2012;36(5):719-723. Published online October 31, 2012; DOI: https://doi.org/10.5535/arm.2012.36.5.719

Abstract
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This study reports a rare case of ulnar neuropathy around the arm with Martin-Gruber anastomosis of a moderate conduction block in the forearm segment and a severe conduction block in the arm segment. Inching tests and ultrasonography showed a lesion between 12 and 14 cm from the medial epicondyle. It is concluded that axilla stimulation may provide diagnostic clues, and inching tests and ultrasonography may be helpful for localizing a lesion.

Citations

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Prevalence of Martin-Gruber Anastomosis in Healthy Subjects: An Electrophysiological Study from Raigarh, Chhattisgarh
Arghya Sur, MiteshM Sinha, JaideoM Ughade
Neurology India.2021; 69(4): 950. CrossRef
Median-to-Ulnar Nerve Communication in Carpal Tunnel Syndrome: An Electrophysiological Study
Vincenzo Di Stefano, Andrea Gagliardo, Filomena Barbone, Michela Vitale, Laura Ferri, Antonino Lupica, Salvatore Iacono, Antonio Di Muzio, Filippo Brighina
Neurology International.2021; 13(3): 304. CrossRef

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Original Article

Anastomosis of Motor Fibers between Median and Ulnar Nerve in the Forearm: an Electrophysiological Study.: Lee, Soon Gul , Bang, Heui Je; J Korean Acad Rehabil Med 2008;32(3):305-312.

Abstract
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Objective
To evaluate the frequency of forearm anastomosis in healthy Korean subjects. Method: Healthy Korean adult subjects (70 males, 30 females) were included. Median and ulnar nerves were stimulated at wrist and elbow and recorded with the surface electrodes over abductor pollicis brevis (APB), first dorsal interossei (FDI) and abductor digiti quinti (ADQ). Results: Martin-Gruber anastomosis (MGA) was found in 18 males and 8 females (26/100, 26%). MGA was found in 37 arms (18.5%). But, Marinacci anastomosis was not observed. For each type of MGA, type II was found in 36 arms (97.3%) whereas type I was found in 11 arms (29.7%), and type III was found in 1 arm (2.7%). Anastomosis was comprised 67.6% of type II, 2.7% of type III, and 29.7% of coexistence of type II and type I. Average innervation ratio of crossing fibers was the highest in FDI (16.2%). Conclusion: Compound muscle action potential (CMAP) comparison method using modified incremental technique is a simple and sufficient method for evaluating forearm anastomosis without stimulus spread to adjacent nerve. In evaluating MGA, the FDI is a very important muscle because of high frequency and innervation ratio. (J Korean Acad Rehab Med 2008; 32: 305-312)