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Median-ulnar anastomosis to thenar, hypothenar, and first dorsal interosseous muscles: Collision technique confirmation

✍ Scribed by Howard W. Sander; Christine Quinto; Sudhansu Chokroverty

Publisher: John Wiley and Sons
Year: 1997
Tongue: English
Weight: 42 KB
Volume: 20
Category: Article
ISSN: 0148-639X
DOI: 10.1002/(sici)1097-4598(199711)20:11<1460::aid-mus17>3.0.co;2-5

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✦ Synopsis

Median-ulnar anastomosis (Martin-Gruber anastomosis; MGA) is traditionally diagnosed based upon changes in compound muscle action potential (CMAP) amplitude following proximal stimulation. We describe a rare patient with a MGA innervating thenar, hypothenar, and first dorsal interosseous muscles. Proximal stimulation, however, evoked CMAPs with striking changes in morphology and area but only minimal amplitude changes, due to concomitant diagnoses of carpal tunnel syndrome and polyneuropathy. Collision studies were therefore required for diagnostic confirmation of the MGA.