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Median and ulnar nerve communication in the forearm: an anatomical and electrophysiological study
Lavent Sarikcioglu1, Muzaffer Sindel, Sibel Ozkaynak
1Departments of Anatomy, Akdeniz University Faculty of Medicine, Antalya, Turkey. levent@med.akdeniz.edu.tr
Background:
We aimed to determine the presence of median and ulnar nerve communication in the forearm by anatomical and electrophysiological examinations in the Anatolian population.
Material/Methods:
30 forearms from 15 preserved cadavers (2 females, 13 males, 42-65 years of age) were carefully dissected to observe median and ulnar nerve communication. We also performed median and ulnar nerve motor conduction studies by recording the thenar, hypothenar and first dorsal interosseous (FDI) muscles, stimulating both nerves at distal and proximal points, and the recordings were compared in 60 forearms (30 subjects, 17 female, 13 male, 34-67 years of age).
Results:
Martin-Gruber communication was observed in 2 of 30 forearms (15 cases) by anatomical examination, in 2 of 60 forearms (30 cases) by electrophysiological examination. No Marinacci communication was found in either anatomical or electrophysiological examinations.
Conclusions:
In this study group, the ratio of MGC was revealed as 3.3% and 6.6%, in the electrophysiological and anatomical examination, respectively. Knowledge of this crossover is of crucial importance in the clinical evaluation of nerve injuries of the median and ulnar nerves, as well as in accurate interpretation of nerve conduction velocity of these nerves, especially in association with carpal tunnel syndrome. Anatomical and electrophysiological classifications of Martin-Gruber communication are reviewed.