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Insidence of Martin-Gruber Anastomosis in Turkey: A Cross-Sectional Study

Received: 27 February 2017     Accepted: 19 April 2017     Published: 15 June 2017
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Abstract

Martin-Gruber anastomosis (MGA) is a well described anostomosis between the median and ulnar nerves in various levels. MGA involves axons leaving either the main trunk of median nerve or the anterior interosseous nerve, crossing through the forearm to join the ulnar nerve and it’s insidence was reported as %10-40. The incidence of this anastomosis is important so that it can cause confusion in the assesment of nerve injuries, compressive neuropathies and it can show different persentages between different population groups. Our objective is to find out an idea about the incidence of MGA in Turkish population. 100 healthy volunteers were inclueded to our study between an age of 17–73 years. Compound muscle action potentials (CMAPs) and motor conduction velocities of median and ulnar nerves were recorded. MGA was made by following criteria: amplitude of CMAP increased after median nerve stimulation at ante-cubital fossa as compared to stimulation at wrist. The corresponding decrease in CMAP amplitude was found after below elbow stimulation as compared with the wrist stimulation in ulnar nerve conduction studies. Martin-Gruber anastomosis was encountered in 29(6 male, 23 female) patients with a persentage of 29% in our present study. The insidence of MGA in Turkish population is high. Understanding the existence of this anatomic variation, its location and its possible presentation is important for the patient’s quality of life. More studies with increased study groups are needed to make us better understand this condition and its insidence in our population.

Published in Clinical Neurology and Neuroscience (Volume 1, Issue 3)
DOI 10.11648/j.cnn.20170103.14
Page(s) 67-69
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Median Nerve, Ulnar Nerve, Anastomosis, Quality of Life

References
[1] Erdem HR, Ergun S, Erturk C, Ozel S. Electrophysiological Evaluation of the Incidence of Martin-Gruber Anastomosis in Healthy Subjects. Yonsei Medical Journal. 2002;43:3:291-5.
[2] Felippe MM, Telles FL, Soares ACL, Felippe FM. Anastomosis between median nerve and ulnar nerve in the forearm. J. Morphol. Sci. 2012;29:1:23-6.
[3] Dogan NU, Uysal II, Seker M. The communications between the ulnar and median nerves in upper limb. Neuroanatomy. 2009;8:15-9.
[4] Pawar S, Gathe B, Jain AP,Singh R. Electrophysiologic study of Martin Gruber Anastomosis (MGA) in Central Indian subject. Int J Biol Med Res. 2011;2:1165-7.
[5] Kaur N, Singla RK, Kullar JS. Martin–Gruber Anastomosis-A Cadaveric Study in North Indian Population. Journal of Clinical and Diagnostic Research. 2016;10:2:9-11.
[6] Cavalheiro CS, Filho MR, Pedro G, Caetano MF, Vieiraa LA, Caetano EB. Clinical repercussions of Martin-Gruber anastomosis: anatomical study. Rev Bras Ortop. 2016;51(2):214-23.
[7] Khosrawi S, Kianimehr L, Andalib S. The prevalence of Martin-Gruber anastomosis in Iranian subjects by electrodiagnostic criteria. Iran J Neurol. 2015;14:4:231-2.
[8] Kate NN, Teli CG, Gajbhiye R, Ambareesha K, Suresh M. A study to analyze the prevalence of nervous anastomosis (Martin–Gruber) in medical students. National Journal of Physiology, Pharmacy and Pharmacology. 2015;5:185-9.
[9] Prates LC, Carvalho VC, Prates JC, Langone F, Esquisatto MAM. The Martin-Gruber Anastomosis in Brazilians: An Anatomical Study. Braz. J. morphol. Sci. 2003;20:3:177-18.
[10] Hodzic R, Piric N, Hodzic M, Kojic B. Electrophysiological Evaluation of the Incidence of MartinGruber Anastomosis in Healthy Bosnian Population. Macedonian Journal of Medical Sciences. 2011;4:4:376-9.
[11] Ayramlou H, Najmi S, Yazdchi M, Naeimi M, Pourabolghasem S. Study of Prevalence of Martin-Gruber Anomaly in Patients with Carpal Tunnel Syndrom. Int J Chronic Dis Ther. 2015;1:2:5-8.
[12] NK Nilesh, GT Chandrika, G Ratnesh, A Kondam, M Suresh. A study to analyze the prevalence of nervous anastomosis (Martin–Gruber) in medical students. Natl J Physiol Pharm Pharmacol. 2015; 5(3): 185-9.
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  • APA Style

    Hakan Levent GUL. (2017). Insidence of Martin-Gruber Anastomosis in Turkey: A Cross-Sectional Study. Clinical Neurology and Neuroscience, 1(3), 67-69. https://doi.org/10.11648/j.cnn.20170103.14

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    ACS Style

    Hakan Levent GUL. Insidence of Martin-Gruber Anastomosis in Turkey: A Cross-Sectional Study. Clin. Neurol. Neurosci. 2017, 1(3), 67-69. doi: 10.11648/j.cnn.20170103.14

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    AMA Style

    Hakan Levent GUL. Insidence of Martin-Gruber Anastomosis in Turkey: A Cross-Sectional Study. Clin Neurol Neurosci. 2017;1(3):67-69. doi: 10.11648/j.cnn.20170103.14

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  • @article{10.11648/j.cnn.20170103.14,
      author = {Hakan Levent GUL},
      title = {Insidence of Martin-Gruber Anastomosis in Turkey: A Cross-Sectional Study},
      journal = {Clinical Neurology and Neuroscience},
      volume = {1},
      number = {3},
      pages = {67-69},
      doi = {10.11648/j.cnn.20170103.14},
      url = {https://doi.org/10.11648/j.cnn.20170103.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20170103.14},
      abstract = {Martin-Gruber anastomosis (MGA) is a well described anostomosis between the median and ulnar nerves in various levels. MGA involves axons leaving either the main trunk of median nerve or the anterior interosseous nerve, crossing through the forearm to join the ulnar nerve and it’s insidence was reported as %10-40. The incidence of this anastomosis is important so that it can cause confusion in the assesment of nerve injuries, compressive neuropathies and it can show different persentages between different population groups. Our objective is to find out an idea about the incidence of MGA in Turkish population. 100 healthy volunteers were inclueded to our study between an age of 17–73 years. Compound muscle action potentials (CMAPs) and motor conduction velocities of median and ulnar nerves were recorded. MGA was made by following criteria: amplitude of CMAP increased after median nerve stimulation at ante-cubital fossa as compared to stimulation at wrist. The corresponding decrease in CMAP amplitude was found after below elbow stimulation as compared with the wrist stimulation in ulnar nerve conduction studies. Martin-Gruber anastomosis was encountered in 29(6 male, 23 female) patients with a persentage of 29% in our present study. The insidence of MGA in Turkish population is high. Understanding the existence of this anatomic variation, its location and its possible presentation is important for the patient’s quality of life. More studies with increased study groups are needed to make us better understand this condition and its insidence in our population.},
     year = {2017}
    }
    

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    AB  - Martin-Gruber anastomosis (MGA) is a well described anostomosis between the median and ulnar nerves in various levels. MGA involves axons leaving either the main trunk of median nerve or the anterior interosseous nerve, crossing through the forearm to join the ulnar nerve and it’s insidence was reported as %10-40. The incidence of this anastomosis is important so that it can cause confusion in the assesment of nerve injuries, compressive neuropathies and it can show different persentages between different population groups. Our objective is to find out an idea about the incidence of MGA in Turkish population. 100 healthy volunteers were inclueded to our study between an age of 17–73 years. Compound muscle action potentials (CMAPs) and motor conduction velocities of median and ulnar nerves were recorded. MGA was made by following criteria: amplitude of CMAP increased after median nerve stimulation at ante-cubital fossa as compared to stimulation at wrist. The corresponding decrease in CMAP amplitude was found after below elbow stimulation as compared with the wrist stimulation in ulnar nerve conduction studies. Martin-Gruber anastomosis was encountered in 29(6 male, 23 female) patients with a persentage of 29% in our present study. The insidence of MGA in Turkish population is high. Understanding the existence of this anatomic variation, its location and its possible presentation is important for the patient’s quality of life. More studies with increased study groups are needed to make us better understand this condition and its insidence in our population.
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Author Information
  • Department of Neurology, Maltepe Ersoy Hospital, Istanbul, Turkey

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