scholarly journals The Incidence and Characteristics of Marinacci Anastomosis: An Anatomical Study

2020 ◽  
Vol 5 (03) ◽  
Author(s):  
Renata Hodzic ◽  
Mirsad Hodzic ◽  
Ermina Iljazovic ◽  
Nermina Piric ◽  
Sanela Zukic
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Anatomical Study ◽  
Ulnar Artery ◽  
Hand Muscles ◽  
Time Period ◽  
Clinical Centre ◽  
Fresh Frozen ◽  
The Right ◽  
Anatomical Research

Marinacci anastomosis, also known as Ulnar-Median anastomosis, is an anastomosis in which the branch anastomotic originates proximally in the ulnar nerve and unites distally with the median nerve. A purpose of this study was to determine the incidence and  the characteristics of Marinacci anastomosis in the Bosnian population. The 60 anterior forearms of fresh frozen adult cadavers were dissected in the Department of Pathology,  University Clinical Centre Tuzla and the morgue of Tuzla during a time period of two years. The Marinacci anastomosis was evidenced in one male forearm in the right side behind the ulnar artery, following an transversal course of 5.2 cm until its connection with the median nerve in only one branch. The incidence of Marinacci anastomosis was 1.67%. Since this anastomosis can expalin some cases where injuries in the forearm nerves are not reflected in the hand muscles, it is important to study. Our study contributes to a limited research on the Marinacci anastomosis, a condition that is rarely found and reported in anatomical research.

ANATOMICAL STUDY OF ARCADE OF STRUTHERS

Hand Surgery ◽  
2010 ◽  
Vol 15 (03) ◽  
pp. 157-159 ◽  
Author(s):  
Piyapong Tiyaworanan ◽  
Surut Jianmongkol ◽  
Tala Thammaroj
Keyword(s):  
Ulnar Nerve ◽  
Anatomical Study ◽  
Medial Epicondyle ◽  
Anatomical Location ◽  
Greater Tuberosity ◽  
Lateral Epicondyle ◽  
Surgical Exploration ◽  
Fresh Frozen ◽  
The Mean ◽  
Proximal Border

The incidence and the anatomical location of the arcade of Struthers as related to the arm length were studied in 62 arms of adult fresh-frozen cadavers. The distance between the greater tuberosity and the lateral epicondyle was designated as the arm length. The arcades of Struthers were identified in 85.4%. The mean arm length was 27.85 ± 1.3 cm. The mean of the distance between proximal border of the arcade of Struthers and the medial humeral epicondyle was 8.24 ± 2.06 cm. The mean ratio between the distance from the proximal border of the arcade to the tip of the medial epicondyle and arm length was 0.29 ± 0.07. We concluded that the anatomical location of the arcade as related to the arm length was 29% proximally, from the tip of the medial epicondyle. This report of the anatomical location of the arcade of Struthers related to the arm length can be useful to identify this structure in the arms which have differences in arm length during the surgical exploration and anterior transposition of the ulnar nerve procedures.

scholarly journals Flexor Pollicis Brevis Muscle. Anatomical Study and Clinical Implications

2017 ◽  
Vol 11 (1) ◽  
pp. 1321-1329
Author(s):  
Edie Benedito Caetano ◽  
Yuri da Cunha Nakamichi ◽  
Renato Alves de Andrade ◽  
Maico Minoru Sawada ◽  
Mauricio Tadeu Nakasone ◽  
...  
Keyword(s):  
Medical School ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Anatomical Study ◽  
Sao Paulo ◽  
Clinical Implications ◽  
Normal Pattern ◽  
Anatomical Dissection ◽  
Deep Branch ◽  
Catholic University

Introduction: This paper reports anatomical study of nature, incidence, innervation and clinical implications of Flexor Pollicis Brevis muscle (FPB). Material and Methods: The anatomical dissection of 60 limbs from 30 cadavers were performed in the Department of Anatomy of Medical School of Catholic University of São Paulo. Results: The superficial head of FPB has been innervated by the median nerve in 70% and in 30% it had double innervation. The deep head of FPB were absent in 14%, in 65%, occurred a double innervation. In 17.5% by deep branch of ulnar nerve and in 3.6% by recurrent branch of median nerve. Conclusion: The pattern of innervation more frequent in relationship to the flexor pollicis brevis muscle and should be considered as a normal pattern is that superficial head receives innervation of branches of median nerve and the deep head receives innervation of ulnar and median nerve.

scholarly journals Uncommon course of the ulnar artery through the pronator teres muscle

1970 ◽  
Vol 52 (195) ◽  
pp. 946-948
Author(s):  
Katerina Vymazalová ◽  
Lenka Vargová ◽  
Marek Joukal
Keyword(s):  
Median Nerve ◽  
Anatomical Variation ◽  
Ulnar Artery ◽  
Predisposing Factor ◽  
Anatomical Structures ◽  
Pronator Teres ◽  
Flexor Carpi Ulnaris ◽  
Cubital Fossa ◽  
The Right ◽  
Flexor Digitorum

In this paper, we describe a very rare variant in the course of the ulnar artery that we encountered in dissecting the right upper limb of a 74-year-old man. The ulnar artery arose standardly from the brachial artery in the cubital fossa. However, its ensuing course differed from the norm. The artery entered together with the ulnar vein and median nerve into the pronator canal (between the humeral and ulnar heads of the pronator teres). Further, the ulnar artery descended classically to the ulnar side of the forearm between the flexor carpi ulnaris and flexor digitorum superficialis. Knowledge of this variation in the course of the ulnar artery may have significance in clinical practice because accumulation of anatomical structures in the pronator canal could be a predisposing factor for the compression of nerve or blood vessels. Keywords: anatomical variation; median nerve; pronator canal; pronator teres muscle; ulnar artery.  

PEDICLED HYPOTHENAR FAT FLAP FOR MEDIAN NERVE COVERAGE IN RECALCITRANT CARPAL TUNNEL SYNDROME

Hand Surgery ◽  
2000 ◽  
Vol 05 (01) ◽  
pp. 33-40 ◽  
Author(s):  
Ch. Mathoulin ◽  
J. Bahm ◽  
S. Roukoz
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Anatomical Study ◽  
Ulnar Artery ◽  
Transverse Carpal Ligament ◽  
Carpal Tunnel Surgery ◽  
Tunnel Syndrome ◽  
Normal Nerve Conduction

We report the use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome. Forty-five patients with recurrent symptoms after previous carpal tunnel surgery were included in this study. Patients with incomplete release of the transverse carpal ligament were not included. We performed an anatomical study on 30 cadavers. The original technique with the section of the deep branch of ulnar artery was modified. The flap could be transferred onto the median nerve without stretching. The median follow-up was 45 months (range, 12–80 months). Pain completely disappeared in 41 patients with normal nerve conduction. Based on clinical and electromyographic signs, the global results showed excellent results (49%), 19 good results (45%), two average results (4.5%) and two failures (2%). The use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome is a simple and efficient technique which improves the trophic environment of the median nerve and relieves pain.

Anatomy of the palmar branch of the ulnar nerve: application to ulnar and median nerve decompressive surgery

2011 ◽  
Vol 114 (1) ◽  
pp. 263-267 ◽  
Author(s):  
R. Shane Tubbs ◽  
Jason M. Rogers ◽  
Marios Loukas ◽  
Ayhan Cömert ◽  
Mohammadali M. Shoja ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Ulnar Artery ◽  
Medial Epicondyle ◽  
Palmar Arch ◽  
Medial Side ◽  
Fourth Digit ◽  
Palmar Cutaneous Branch ◽  
Cutaneous Branch ◽  
The Mean

Object The palmar cutaneous branch of the ulnar nerve (PCUN) has received little attention in the literature, and to the authors' knowledge, has received no attention in the neurosurgical literature. The present study was performed to help the surgeon minimize postoperative complications of nerve decompression at the wrist. Methods Forty cadaveric upper limbs underwent dissection of the ulnar nerve in the forearm, at the wrist, and in the palm. The PCUN was investigated and when identified, measurements were made and relationships documented between this cutaneous branch and the ulnar artery. The length and width of the PCUN were measured, as was the distance from the medial epicondyle of the humerus to the origin of the PCUN from the ulnar nerve. Results A PCUN was found on 90% of sides. The origin of the PCUN from the ulnar nerve was found to lay a mean of 14.3 cm distal to the medial epicondyle. The mean length and width of this branch were 13 and 0.08 cm, respectively. In the forearm, the PCUN traveled lateral to the ulnar artery on 75% of sides and on the medial side of this vessel on the remaining sides. The PCUN perforated the fascia of the anterior forearm just proximal to the distal wrist crease. In the palm, the PCUN traveled superficial to the superficial palmar arch on all but 5 sides, where it traveled deep to this vascular structure's distal extent. On 2 sides each, the PCUN communicated with the superficial and deep ulnar nerves. On 2 sides, the PCUN communicated with the palmar cutaneous branch of the median nerve. The majority of the terminal fibers of the PCUN were found on the ulnar side of a hypothetical line drawn longitudinally through the fourth digit and supplied an area roughly 3 × 3 cm over the proximal medial palm. Conclusions The authors hope that the present data may be useful to the surgeon during decompressive procedures at the wrist, such as carpal tunnel and the Guyon canal. Based on this study, skin incisions of the palm made longitudinally along a line through the middle of the fourth digit would minimize injury to the PCUN.

scholarly journals Gantzer muscles; a study on 50 cadaveric upper limbs

2015 ◽  
Vol 04 (04) ◽  
pp. 179-185
Author(s):  
Roshni Bajpe ◽  
Tarakeshwari R. ◽  
Shubha R.
Keyword(s):  
Median Nerve ◽  
Ulnar Artery ◽  
South Indian Population ◽  
Upper Limbs ◽  
Compressive Neuropathy ◽  
South Indian ◽  
Anterior Interosseous Nerve ◽  
The Right ◽  
Deep Flexors ◽  
Flexor Digitorum

Abstract Background : Gantzer muscle is the name given to the additional head of Flexor Digitorum Profudus (FDP) or Flexor Pollicis Longus (FPL). It connects the superficial flexors and deep flexors of forearm. It sometimes may be related to Anterior Interosseous Nerve (AIN) and Ulnar artery causing Compressive Neuropathy or Vascular symptoms. Aim: To assess incidence of Gantzer muscle in South Indian population, its morphology and clinical significance. Materials and methods: The study was carried out on 50 upper limbs dissected by first year M.B.B.S students. Results : Nine upper limbs showed the presence of Gantzer muscle, three belonged to the right and six belonged to the left. Observations : Additional heads were associated as follows: From FDP-2 and from FPL-7. Innervation was either from Median nerve, Anterior Interosseous nerve or Ulnar nerve. Superficially median nerve was related, deep relations were Ulnar artery and Anterior Interosseous nerve. In one case, Median nerve and artery were related superficially. Conclusion: Gantzer muscle is important clinically as a cause of vascular or nerve compression.

scholarly journals Distally Based Pedicled Flexor Carpi Ulnaris Muscle Flap: An Anatomical Study and Clinical Application

Hand ◽  
2018 ◽  
Vol 14 (1) ◽  
pp. 121-126
Author(s):  
Kai Yang ◽  
David Rivedal ◽  
Lucas Boehm ◽  
Ji-Geng Yan ◽  
James Sanger ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Median Nerve ◽  
Average Distance ◽  
Muscle Flap ◽  
Anatomical Study ◽  
Ulnar Artery ◽  
Soft Tissue Coverage ◽  
Ulnar Styloid ◽  
Flexor Carpi Ulnaris ◽  
Distally Based

Background: Proximally based, pedicled flexor carpi ulnaris (FCU) muscle flap has been described previously for soft tissue coverage of the proximal forearm and elbow. No studies have been done on the distal muscular perforators and its use as a distally based flap. Methods: Ten fresh-frozen cadaveric dissections were done. Specimens were injected with latex to facilitate identification of the perforators. Distal muscular perforators were dissected and distances of the pedicles from the distal wrist crease and ulnar styloid were measured and recorded. A clinical case is also presented where a distally based FCU muscle flap was used for coverage in a patient with median nerve neuroma. Results: A distal muscular perforator and a second more proximal perforator were identified in all specimens. The average distance from the most distal muscular perforator to the ulnar styloid was 3.0 cm. The average distance to the wrist crease was 4.6 cm. The more proximal perforators had an average distance to the ulnar styloid and wrist crease of 7.3 cm and 8.8 cm, respectively. At 7 months post-op, the patient who underwent median nerve neurolysis and coverage with pedicled FCU flap had much improved sensation, with complete resolution of pain and tingling, and without any functional deficits. Conclusions: The use of a distally based FCU muscle flap is a good option for soft tissue coverage of the distal forearm, wrist, and hand. The distal muscular perforators from the ulnar artery exhibit a relatively consistent anatomy.

scholarly journals Real Color Sectioned Images and Correspondence with Ultrasound Images of the Palmar Wrist

2021 ◽  
Vol 12 (1) ◽  
pp. 299
Author(s):  
Seul Ki Kim ◽  
Mi-Sun Hur ◽  
Jin Seo Park
Keyword(s):  
High Resolution ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Ulnar Artery ◽  
Ultrasound Images ◽  
Flexor Pollicis Longus ◽  
Longus Tendon ◽  
Pathological Lesions ◽  
Flexor Pollicis Longus Tendon

The aim of this study was to identify sequential changes in the actual sites and shapes of wrist structures on the high-resolution sectioned images and to compare these with those on ultrasound (US) images. These images of the wrist may yield guidelines for diagnosing various pathological lesions in the wrist. In the sectioned images of a whole cadaver body, and the images including the wrist were selected, and part of the hand was cropped. A wrist of one healthy Korean subject was scanned by ultrasonography to obtain US images of the wrist. Wrist structures were identified and labeled in detail on the sectioned images and the corresponding US images. Serial changes of the sites and shapes of the wrist structures mainly occurred in the bones, median nerve, ulnar artery, ulnar nerve, and the flexor pollicis longus tendon, along with thickening of the thenar and hypothenar muscles. The present results could provide a new guide for anatomy mapping, diagnosing, and detecting various lesions of the wrist. They can also be useful and effective for educational purposes related to interpreting US images.

scholarly journals Estimation of Tactile Discriminatory Fitness in Hands of Public Transport Drivers

2020 ◽  
Vol 16 (1) ◽  
pp. 1-5
Author(s):  
Ojashwi Nepal ◽  
Samjhana Thapa ◽  
Roshan Kasti ◽  
Reena Kumari Jha ◽  
Mrigendra Amatya
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Public Transport ◽  
Middle Finger ◽  
Left Hand ◽  
Palmar Surface ◽  
Significant Difference ◽  
The Mean ◽  
The Right ◽  
Two Populations

Background: Public transport drivers are constantly being exposed to stimuli and are at risk of disorder of peripheral nervous system which can be further complicated by comorbidities. Thus, we wanted to examine intactness of tactile discriminatory ability in healthy drivers by comparing it to healthy samples of non-driving population. Since two point discrimination (TPD) test is frequently used for neurological assessment of tactile stimulation we determined and compared various locations in hands of two populations. Methods: Participants were asked to answer whether they feel one point or two points touch by blunted end of simple compass divider in their hand. The minimum distance between the points at which the participants could answer correctly was noted as two point discrimination value. Results: Drivers had TPD range of 2-4mm with mean 2.53±0.62 and, 1-4mm with mean 2.6±0.72 at middle finger of right and left hand respectively. Following t-test between drivers versus students, significant difference in the mean TPD value in the proximal palm supplied by median nerve (p=0.016) and proximal palm corresponding to ulnar nerve (p=0.032) on the right hand was found. On the left hand, significant difference in the mean TPD value is found in the proximal palm corresponding to median nerve (p=0.008) and ulnar nerve (p=0.043) respectively.   Conclusion: Healthy public transport drivers have less tactile discriminating prowess at proximal palmar surface of hand. Examined distal phalanges and distal palm showed no significant difference in mean of TPD values for healthy drivers versus students.

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