Abstract
A case with a median nerve lesion at the wrist without thenar atrophy and another with an ulnar nerve lesion at the elbow sparing the first dorsal interosseous are reported. Simultaneous multiple channel recording demonstrated in the first case a dual innervation of the abductor pollicis brevis by median and ulnar fibers via a Martin-Gruber anastomosis. In the second case, the cross over of the median fibers innervating the first dorsal interosseous was very proximal in the antecubital fossa. Stimulation at discrete points documented that the communicating fibers from the median joined the ulnar nerve 3 cm below the medial epicondyle.
Sommario
Vengono descritti due casi: il primo con una lesione del nervo mediano al polso senza atrofia della eminenza thenar, il secondo con una lesione del nervo ulnare al gomito che risparmiava il muscolo primo interosseo dorsale. La tecnica di registrazione simultanea con canali multipli ha consentito di dimostrare nel primo caso una innervazione duplice (mediano ed ulnare) del muscolo adbuttore breve del pollice tramite una anastomosi di Martin-Gruber. Nel secondo caso, l'incrocio verso il nervo ulnare delle fibre a partenza dal mediano e destinate ad innervare il muscolo primo interosseo dorsale, era molto prossimale nella fossa antecubitale. La stimolazione nervosa in punti discreti permetteva di dimostrare che le fibre anastomotiche provenienti dal nervo mediano si univano all'ulnare 3 cm al di sotto dell'epicondilo mediale.
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Uncini, A., Lange, D.J. & Lovelace, R.E. Anomalous intrinsic hand muscle innervation in median and ulnar nerve lesions: An electrophysiological study. Ital J Neuro Sci 9, 497–503 (1988). https://doi.org/10.1007/BF02337169
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DOI: https://doi.org/10.1007/BF02337169