Electrophysiological Findings in Common Median-Ulnar Nerve Interconnections and Their Clinical Implications.

J Hand Surg Am · Oct 2019 · Review

Martin SP, Schauer KT, Czyrny JJ, Ablove RH

UBMD Orthopaedics & Sports Medicine, Buffalo, NY

Hand & Upper Extremity

SUMMARY — THE REDUCTIONThis review details the anatomy and electrodiagnostic patterns of median-ulnar nerve interconnections, emphasizing bilateral proximal-distal nerve testing to avoid misdiagnosis.
Abstract, as published

Median and ulnar nerve interconnections commonly occur in the brachial plexus, forearm, and hand. Each is classified based on location, fiber type (sensory fibers, motor fibers, or both), and directionality (ie, carrying fibers from median to ulnar or vice versa). There are 4 main interconnections found in the forearm and hand: Martin-Gruber and Marinacci anastomoses in the forearm and Riche-Cannieu and Berrettini anastomoses in the hand. The presence of an interconnection may skew electrodiagnostic findings, possibly resulting in misdiagnosis and iatrogenic injury. Clinicians should perform nerve studies of both nerves at proximal and distal stimulation sites to rule out interconnections and guide treatment. This review details anatomy, electrodiagnostic findings, and clinical approach.

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