A case of ulnar nerve section at the elbow alleviated by Martin-Gruber communicating branch. Diagnostic characterization

2021 ◽  
Author(s):  
J.M. Pardal-Fernandez ◽  
A. Grande-Martin ◽  
B. Godes-Medrano
Keyword(s):  
Ulnar Nerve ◽  
Nerve Section ◽  
Communicating Branch

Electrophysiological evidence for overlapping dominant and latent inputs to somatosensory cortex in squirrel monkeys

1995 ◽  
Vol 74 (2) ◽  
pp. 722-732 ◽  
Author(s):  
C. E. Schroeder ◽  
S. Seto ◽  
J. C. Arezzo ◽  
P. E. Garraghty
Keyword(s):  
Ulnar Nerve ◽  
Radial Nerve ◽  
Current Flow ◽  
Current Source ◽  
Squirrel Monkeys ◽  
Spatiotemporal Pattern ◽  
Nerve Section ◽  
Multiunit Activity ◽  
Preferential Access ◽  
Area 3B

1. The pattern of reorganization in area 3b of adult primates after median or ulnar nerve section suggests that somatic afferents from the dorsum of the hand, carried by the radial nerve, have preferential access to the cortical territories normally expressing glabrous inputs carried by the median and ulnar nerves. A likely mechanism underlying preferential access is preexisting, but silent, radial nerve inputs to the glabrous region of cortex. 2. We tested this by comparing the effects of electrical stimulation of median or ulnar versus radial nerves, on responses in the hand representation of area 3b. Laminar current source density and multiunit activity profiles were sampled with the use of linear array multicontact electrodes spanning the laminae of area 3b. Data were obtained from three squirrel monkeys anesthetized during recording. 3. Compared with colocated median or ulnar nerve responses, the radial nerve response had 1) an initial short-latency response in the middle laminae that was subtle; there was a small transmembrane current flow component without a discernable multiunit activity correlate; and 2) a laminar sequence and distribution of activity that was similar to those of the median or ulnar nerve responses (i.e., initial activation of the middle, followed by upper and lower laminae), but the significant current flow and multiunit response to radial nerve stimulation occurs 12–15 ms later. 4. Normal corepresentation of nondominant dorsum hand (radial) inputs with the dominant (median or ulnar) inputs in the glabrous hand surface representation provides a clear vehicle for the biased patterns of reorganization occurring after peripheral nerve section. The initial, “subtle” activity phase in the nondominant response is believed to reflect intracortical inhibition, and the later “significant” response phase, a rebound excitation, possibly compounded by an indirect or extralemniscal input. The spatiotemporal pattern of nondominant input is proposed to play a role in normal somatosensory perception.

The surgical anatomy of ulnar and median nerve communications in the palmar surface of the hand

2007 ◽  
Vol 106 (5) ◽  
pp. 887-893 ◽  
Author(s):  
Marios Loukas ◽  
Robert G. Louis ◽  
Lynsey Stewart ◽  
Barry Hallner ◽  
Terry DeLuca ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Ring Finger ◽  
Surgical Anatomy ◽  
Type I ◽  
Risk Area ◽  
Type Iv ◽  
Palmar Surface ◽  
Communicating Branch ◽  
Communicating Branches

Object Sensation in the palmar surface of the digits is supplied by the median and ulnar nerves, with the boundary classically being the midline of the ring finger. Overlap and variations of this division exist, and a communicating branch between the ulnar and median nerve could potentially explain further variations in digital sensory innervations. The aim of this study was to examine the origin and distribution of the communicating branch between the ulnar and median nerves and to apply such findings to the risk involved in surgical procedures in the hand. Methods The authors grossly and endoscopically examined 200 formalin-fixed adult human hands obtained in 100 cadavers, and a communicating branch was found to be present in 170 hands (85%). Of the specimens with communicating branches, the authors were able to identify four notable types representing different points of connections of the branches. The most common, Type I (143 hands, 84.1%), featured a communicating branch that originated proximally from the ulnar nerve and proceeded distally to join the median nerve. Type II (12 hands, 7.1%) designated a communicating branch that originated proximally from the median nerve and proceeded distally to join the ulnar nerve. Type III (six hands, 3.5%) designated a communicating branch that traversed perpendicularly between the median and ulnar nerves in such a way that it was not possible to determine which nerve served as the point of origin. Type IV (nine hands, 5.3%) designated a mixed type in which multiple communicating branches existed, arising from both ulnar and median nerves. Conclusions According to the origin and distribution of these branching patterns, the investigators were able to define a risk area in which the communicating branch(es) may be subject to iatrogenic injury during common hand procedures.

Digital Innervation Patterns Following Median or Ulnar Nerve Laceration and their Correlation to Anatomic Variations of the Communicating Branch Between these Nerves

2004 ◽  
Vol 29 (4) ◽  
pp. 351-355 ◽  
Author(s):  
J. PETER W. DON GRIOT ◽  
J. JORIS HAGE ◽  
PETER J. M. DE GROOT
Keyword(s):  
Ulnar Nerve ◽  
Ring Finger ◽  
Nerve Transection ◽  
Anatomic Variations ◽  
The Third ◽  
Communicating Branch ◽  
Innervation Patterns ◽  
The One

The midline of the ring finger is classically considered as the neural watershed between the median and ulnar nerve sensory territories on the palmar surfaces of the fingers. Variations of this division exist and may be explained by a communicating branch between the third and fourth common digital nerves. The palmar sensibility patterns of fingers were assessed with Semmes Weinstein filaments after either a complete median or an ulnar nerve transection in 43 patients. Eight out of nine observed sensibility patterns could be explained by known anatomic types and subtypes of the communicating branch. The type of communicating branch, but not its subtype, could be established in the one remaining pattern.

Sensory Innervation of the Little Finger by an Anomalous Branch of the Median Nerve Associated with Recurrent, Atypical Carpal Tunnel Syndrome

1995 ◽  
Vol 20 (1) ◽  
pp. 42-43 ◽  
Author(s):  
W. R. SAEED ◽  
D. M. DAVIES
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Complete Resolution ◽  
Surgical Decompression ◽  
Sensory Innervation ◽  
Communicating Branch ◽  
Tunnel Syndrome ◽  
Anomalous Branch ◽  
Little Finger ◽  
Sensory Communication

Superficial sensory communication between the ulnar and median nerves is well recognized. In the vast majority of cases this communication is from the ulnar nerve to the median nerve. We report a case in which a communicating branch passed from the median nerve to the ulnar nerve immediately proximal to the wrist to supply sensation to the little finger. The presence of this branch correlated with the presence of symptoms which had persisted in spite of conventional open carpal release 7 years earlier. Surgical decompression of this branch led to complete resolution of those symptoms.

Anatomical Variation in the Innervation of the Little Finger: A Case Report

1995 ◽  
Vol 3 (1) ◽  
pp. 47-48
Author(s):  
Pramod K Nelluri ◽  
Achilleas Thoma
Keyword(s):  
Case Report ◽  
Ulnar Nerve ◽  
Peripheral Nerves ◽  
Anatomical Variation ◽  
Digital Nerve ◽  
Innervation Pattern ◽  
Dorsal Aspect ◽  
Dorsal Branch ◽  
Communicating Branch ◽  
Little Finger

The anatomy of peripheral nerves and innervation pattern in the upper extremity has been studied extensively by various authors over the decades. Anomalies and normal variations of all three major nerves have been described in the sensory patterns on both the palmar and dorsal aspect of the hand. This is a case report of a 29-year-old male who presented with a hypothenar mass. On exploration, he was found to have an abnormal communicating branch between the palmar ulnar digital nerve to the little finger and the dorsal branch of the ulnar nerve. This anomaly has not previously been described in the literature.

scholarly journals Innervation of the Flexor Digitorum Profundus: A Systematic Review

2017 ◽  
Vol 26 (2) ◽  
pp. 120-125
Author(s):  
Kun Hwang ◽  
Seung Jun Bang ◽  
Sook Hyun Chung
Keyword(s):  
Systematic Review ◽  
Nerve Injury ◽  
Ulnar Nerve ◽  
Flexor Digitorum Profundus ◽  
Communicating Branch ◽  
Anterior Interosseous Nerve ◽  
Flexor Digitorum ◽  
Forearm Length

Purpose: The aim of this study was to review the innervation of the flexor digitorum profundus (FDP). Methods: In PubMed and Scopus, terms (Flexor digitorum profundus OR FDP) AND (innervation OR nerve) were used, resulting in 233 and 281 papers, respectively. After excluding 142 duplicates, 73 abstracts were reviewed. Forty-seven abstracts were excluded, 26 full papers were reviewed, and 17 papers were analyzed. Results: In most cases (97.6%), the index FDP was innervated by the anterior interosseous nerve (AIN). Dual innervation from the AIN and ulnar nerve (UN) was observed in 2.4% of papers. In majority (76.8%), the middle FDP received dual innervation from the AIN and the UN. The rest was innervated by the AIN only (22.0%) or the UN only (1.2%). In most cases (85.4%), the ring FDP was innervated by the UN only. The rest (14.6%) received dual innervation from the AIN and the UN. In majority of cases (64.6%), the little FDP was innervated by the UN only. The rest (35.4%) received dual innervation from the AIN and the UN. The AIN entered the FDP at 107.63 (8.80) mm from the elbow, corresponding to 26.75% (2.17%) of the forearm length, measured proximally. The average number of AIN branches to the FDP was 2.27 (1.33). The average number of UN branches to the FDP was 1.37 (0.94). In 8.8% of limbs, a communicating branch supplied the FDP. Among the limbs with a communicating branch, 32.3% had branches supplying the FDP. Conclusion: The results of this study may be useful in managing nerve injury patients.

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