Co-existence of Riche-Cannieu communications and Berretinni communications
Keywords:
Median nerve, Ulnar nerve, CommunicationsAbstract
Median nerve is formed by union of lateral and medial roots arising from the corresponding cords of the brachial plexus. Ulnar nerve arises from the medial cord of brachial plexus itself. Only few communications between the median and ulnar nerve have been reported and described in the available literature. During routine dissection of the upper limb of a male cadaver for teaching undergraduate medical students, a variation was observed in the course of median nerve and ulnar nerve communications in palm. A very rare communication was found in which there is superficial and deep communication between ulnar and median nerve was observed only in one male cadaver (1.25%). This type of communication was not found in any other cadaver so far. This dual ansa formation between branches of ulnar and median nerve by communicating branches at superficial and deep levels in palm is rare to observe in which there is co-existence of Berretini Communications and Riche-Cannieu Communications is found in one hand only.
References
Standring SM. Gray’s Anatomy. 39th Ed., New York, Churchill Livinstone. 2005; p. 848, 864, 885–886.
Amoiridis G, Vlachonikolis IG. Verification of the median-to-ulnar and ulnar-to-median nerve motor fiber anastomosis in the forearm: an electrophysiological study. Clin. Neurophysiol 2003;114:94-8.
Don Griot JPWD, Zuidam JM, Kooten EOV, Prose LP, Hage JJ. Anatomic study of the ramus communicans between the ulnar and median nerves. J. Hand Surg 2000; 25A: 948–954.
Ferrari GP, Gilbert A. The superficial anastomosis on the palm of the hand between the ulnar and median nerves. J. Hand Surg 1991; 16B: 511–514.
Loukas M, Louis ZR Jr, Stewart L, Hallner B, Deluca T, Morgan W. The surgical anatomy of ulnar and median nerve communications in the palmar surface of the hand. J Neurosurg 2007; 106: 887–893.
Univer Dogan N, Uysal IL, Seker M. The communications between the ulnar and median nerves in upper limb. Neuroanat 2009 Feb 25; 8: 15-19.
Bunnell S. Surgery of the Hand. 3rd ed. JB Lippincott, Philadelphia, 1956, p 54.
Mannerfelt L. Studies on the hand in ulnar nerve paralysis. A clinical-experimental investigation in normal and anomalous innervation. Acta Orthop Scand 1966 : Suppl 87 part 2 : 19-29.
Harness D, Sekeles E. The double anastomotic innervation of thenar muscles. J Anat 1971; 109: 461–466.
Kimura I, Ayyar DR, Lippmann SM. Electrophysiological verification of the ulnar to median nerve communications in the hand and forearm. Tohoku J Exp Med 1983;141:269-74.