Cadaveric Study of Berretini Communications in North Indian Population

Kaur, Neelamjit; Singla, Rajan Kumar; Kullar, Jagdev Singh

doi:10.7860/jcdr/2016/19506.8062

Cited by 4 publications

(6 citation statements)

References 12 publications

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“…Bazı dolaşım faktörlerinin de sinir oluşumunda rol oynadığına inanılmaktadır. Sinyalizasyon sistemindeki farklılıklar sinirlerin anormal gelişimi için faktör olabilir ve bu da sonuçta varyasyonlarla sonuçlanır (9). Üst ekstremitede n. medianus ve n. ulnaris arasındaki bağlantılar hakkındaki araştırmalar devam etmektedir ve literatürde mevcut bir fikir birliği yoktur (10).…”

Section: Discussionunclassified

Palmar Bölgede Nervus Ulnaris ve Nervus Medianus Arasındaki “Ramus Communicans Cum Nervo Ulnari”

Babacan

Deniz

2020

Harran Üniversitesi Tıp Fakültesi Dergisi

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Anatomi kitaplarında n. medianus ve n. ulnaris'in elin palmar bölgesindeki dağılımı radial taraf 3,5 ve ulnar taraf 1,5 parmak (sırasıyla) olacak şekilde tanımlanmıştır. Berrettini, 1741 yılında elin palmar bölgesinde n. medianus ve n. ulnaris arasında bir bağlantı tanımlamıştır. Bu bağlantı "Berrettini anastomozu" olarak literatürde yer almıştır. Elin palmar bölgesindeki bu sinirlerin bağlantısı Terminologia Anatomica'da "ramus communicans cum nervo ulnari" olarak isimlendirilmiştir. Ancak, temel anatomi kitaplarında bu bağlantıya ve detaylarına yer verilmemiştir. 64 yaşındaki erkek kadavranın sağ elinin rutin diseksiyonu esnasında n. ulnaris ile n. medianus arasında bir bağlantı olduğu gözlendi. Bu sinirlere ait dalların dağılımı takip edildi. N. ulnaris'in 1,5; n. medianus'un 2,5 ve n. ulnaris ile n. medianus kökenli ortak dalın dördüncü ve üçüncü parmaklarının yarısına dağıldığı tek taraflı olarak tespit edildi. Sol elde bu bağlantıya rastlanmadı.Literatürde n. ulnaris ve n. medianus kökenli bu sinirin frekansı %4 ile %94 arasında olduğu belirtilmiştir. Tagil ve ark.'nın çalışmasında bu bağlantının Türk popülasyonundaki oranı %60 olarak bulunmuştur. Bu varyasyonun toplumda bulunma sıklığına bağlı olarak bazı yazarlar, elin palmar bölgesinde n. medianus ve n. ulnaris'in dağılımında bu bağlantının normal bir dağılım paterni olarak yer almasını talep etmektedir.

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Section: Discussionunclassified

Palmar Bölgede Nervus Ulnaris ve Nervus Medianus Arasındaki “Ramus Communicans Cum Nervo Ulnari”

Babacan

Deniz

2020

Harran Üniversitesi Tıp Fakültesi Dergisi

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“…44 With its location most often adjacent to the transverse carpal ligament, several authors are in agreement that the BA is at risk of iatrogenic injury during carpal tunnel release surgeries. 3,6,42,43,45 However, Unver Dogan et al suggest that iatrogenic injury is unlikely to occur, explaining that the working area for treatment of carpal tunnel syndrome is superficial to the anastomosis. Risk of damage of BA is also associated with ring finger flexor tendon surgery, Dupuytren fasciectomy, and mobilization of neurovascular island flaps.…”

Section: Berrettini Anastomosismentioning

confidence: 99%

“…While generally considered atypical, the presence of these anatomical variations may impact the presentation of musculoskeletal disorders and surgical outcomes, as well as mandate alteration of surgical approaches. [1][2][3][4][5][6][7] Therefore, knowledge and recognition of these median-ulnar anastomoses by surgeons is clinically significant. The aim of this review is to concisely summarize current literature, to provide clinicians with an easily referenced and comprehensive resource.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Summary of Anastomoses between the Median and Ulnar Nerves in the Forearm and Hand

Smith

Siddiqui

Ebraheim

2019

Journal of Hand and Microsurgery

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Four main presentations of median-ulnar anastomosis exist. Those manifesting in the forearm include Martin–Gruber and Marinacci, while those found in the hand are referred to as Riche–Cannieu and Berrettini. Martin–Gruber anastomosis involves branching of the median nerve proximally to ulnar nerve distally. Marinacci anastomosis, the rarest of all the presentations, is often termed reverse Martin–Gruber, with the ulnar nerve stemming proximally to meet the median nerve distally in the forearm. Riche–Cannieu anastomosis occurs as an interconnection between the recurrent branch of the median nerve and the deep branch of the ulnar nerve in the hand. Berrettini anastomosis is the most frequently encountered of the anomalies and is described as a neural connection between common digital nerves of the ulnar and median nerves. Due to altered innervation patterns, musculoskeletal disorders of the forearm and hand may present with misleading symptoms. Additionally, existence of an anastomosis may require an alteration of surgical methods or be a source of iatrogenic injury. Consequently, knowledge of these anastomoses is crucial to clinical practice. Therefore, the objective of this review is to concisely present the most relevant information regarding median and ulnar anastomoses in the forearm and hand.

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“…This variation can also be of significant use to neurologists and orthopedists while examining cases with sensory loss over the distal part of the upper limb. Care should also be taken to prevent injury of the nerve while performing endoscopic release of carpal tunnel for carpal tunnel syndrome by looking out for the communicating branch prior to the surgery [30]. Ferrari and Gilbert, described a danger zone, defined as an area that extends from the half of the hypothenar eminence limited distally by the transverse crease of the carpal on the palmar region and radially by a longitudinal fold between the thenar and hypothenar eminence, in which there is greater possibility of iatrogenic lesions in the approach to the carpal tunnel [31].…”

mentioning

confidence: 99%

“…Ferrari and Gilbert, described a danger zone, defined as an area that extends from the half of the hypothenar eminence limited distally by the transverse crease of the carpal on the palmar region and radially by a longitudinal fold between the thenar and hypothenar eminence, in which there is greater possibility of iatrogenic lesions in the approach to the carpal tunnel [31]. According to Agge et al, and Jimenez et al, these lesions are more frequent after endoscopic carpal tunnel release, although this technique has lower risk of complications in general, and provides quicker return to functional activities [30,32,33]. In the present study to reported an anatomical variation of communication between median and musculocutaneus nerve, median and ulnar nerve, and ulnar and radial nerve in forearm of rare occurrence and lack of description in available scientific literature.…”

mentioning

confidence: 99%

Nervous Communications In The Upper Limb. A Cadaveric Study

Arquez

2017

int arch med

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Background: Anatomical variations of the terminal branches of the brachial plexus in terms of communication between nerves at the level of upper limb have been reported, these communications were median and musculocutaneous nerve, median and ulnar nerve, radial and ulnar nerve (at level humeral), but communications between the radial and ulnar nerve at level of the forearm are very rare. Methods and Findings: 34 upper extremities of 15 male and 2females embalmed adults cadavers in the laboratory of Morphology of the University of Pamplona. The upper limbs were studied serially during the years 2013-2016. Of the 34 upper limbs studied in the Laboratory of Morphology of the University of Pamplona, in a 75 year-old male cadaver anatomical variations were found, dissected carefully and morphological details were photographed, these variations consisted of nervous communications between median and musculocutaneous nerve in the right and left arm (proximal), in the right arm (distal); median and ulnar nerve in the right forearm; radial and ulnar nerve in the left forearm. Conclusions: IntroductionThe brachial plexus is a complex structure which is divided into roots, trunks, divisions, cords and branches, has supraclavicular and infraclavicular part. The supraclavicular part includes roots, trunks and divisions. The infraclavicular part includes cords and their branches. The brachial plexus is formed by the union of ventral rami of C5, C6, C7, This article is available at: www.intarchmed.com and www.medbrary.com 2 C8 and greater part of T1. These ventral rami are the roots of brachial plexus, almost equal in size but variable in their mode of junction. Ventral rami of C5 and C6 unite at the lateral border of the scalenus medius to form upper trunk and C7 continues as middle trunk while C8 and T1 unite behind scalenus anterior to form lower trunk. All these trunks incline laterally, just above or behind the clavicle where each one bifurcates into anterior and posterior divisions. The anterior divisions of upper and middle trunks unite to form a lateral cord, lateral to the axillary artery and the anterior division of the lower trunk descends at first behind, then medial to the axillary artery, forming medial cord. Posterior divisions of all the three form the posterior cord, at first above and then behind the axillary artery [1]. From the cords arise the terminal branches of the brachial plexus including the musculocutaneous nerve (MCN), median nerve (MN), ulnar nerve (UN), axillary nerve (AN), and radial nerve (RN). The brachial plexus supplies cutaneous and muscular innervation to the upper limb and any injury at this level can lead to significant disability. Variations of the cords and their terminal branches of the brachial plexus are relatively common and have been well documented. It is important for the anatomist, surgeon, anesthesiologist, and radiologist to be aware of anatomical variations that deviate from the classic anatomy [2].The variation in the course, distribution and formation of the brachia...

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Cadaveric Study of Berretini Communications in North Indian Population

Cited by 4 publications

References 12 publications

Palmar Bölgede Nervus Ulnaris ve Nervus Medianus Arasındaki “Ramus Communicans Cum Nervo Ulnari”

Palmar Bölgede Nervus Ulnaris ve Nervus Medianus Arasındaki “Ramus Communicans Cum Nervo Ulnari”

Comprehensive Summary of Anastomoses between the Median and Ulnar Nerves in the Forearm and Hand

Nervous Communications In The Upper Limb. A Cadaveric Study

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