Anastomosis Patterns between the Median and Ulnar Nerves in the Upper Limbs
Arq. bras. neurocir; 40 (2), 2021
Publication year: 2021
There are four types of anastomoses between themedian and ulnar nerves in the upper
limbs. It consists of crossings of axons that produce changes in the innervation of the
upper limbs, mainly in the intrinsic muscles of the hand. The forearm has two
anatomical changes – Martin-Gruber: branch originating close to the median nerve
joining distally to the ulnar nerve; and Marinacci: branch originating close to the ulnar
nerve and distally joining the median nerve. The hand also has two types of
anastomoses, which are more common, and sometimes considered a normal anatomical
pattern – Berrettini: Connection between the common digital nerves of the ulnar
and median nerves; and Riche-Cannieu: anastomosis between the recurrent branch of
the median nerve and the deep branch of the ulnar nerve. Due to these connection
patterns, musculoskeletal disorders and neuropathies can be misinterpreted, and
nerve injuries during surgery may occur, without the knowledge of these anastomoses.
Therefore, knowledge of them is essential for the clinical practice. The purpose of the
present review is to provide important information about each type of anastomosis of
the median and ulnar nerves in the forearm and hand.