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Journal of the Korean Academy of Rehabilitation Medicine 2008;32(3):305-312.
Anastomosis of Motor Fibers between Median and Ulnar Nerve in the Forearm: an Electrophysiological Study.
Lee, Soon Gul , Bang, Heui Je
Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Korea. heuije@hanafos.com
아래팔에서 정중신경과 척골신경간 운동섬유의 문합: 전기생리학적 연구
이순걸, 방희제
충북대학교 의과대학 재활의학교실
Abstract
Objective
To evaluate the frequency of forearm anastomosis in healthy Korean subjects.
Method
Healthy Korean adult subjects (70 males, 30 females) were included. Median and ulnar nerves were stimulated at wrist and elbow and recorded with the surface electrodes over abductor pollicis brevis (APB), first dorsal interossei (FDI) and abductor digiti quinti (ADQ).
Results
Martin-Gruber anastomosis (MGA) was found in 18 males and 8 females (26/100, 26%). MGA was found in 37 arms (18.5%). But, Marinacci anastomosis was not observed. For each type of MGA, type II was found in 36 arms (97.3%) whereas type I was found in 11 arms (29.7%), and type III was found in 1 arm (2.7%). Anastomosis was comprised 67.6% of type II, 2.7% of type III, and 29.7% of coexistence of type II and type I. Average innervation ratio of crossing fibers was the highest in FDI (16.2%).
Conclusion
Compound muscle action potential (CMAP) comparison method using modified incremental technique is a simple and sufficient method for evaluating forearm anastomosis without stimulus spread to adjacent nerve. In evaluating MGA, the FDI is a very important muscle because of high frequency and innervation ratio. (J Korean Acad Rehab Med 2008; 32: 305-312)
Key Words: Martin-Gruber anastomosis, Marinacci anastomosis, Forearm anastomosis, Frequency, Electromyography
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