Kaur Neelamjit, Singla Rajan Kumar, Kullar Jagdev Singh
Associate Professor, Department of Anatomy, Maharishi Markandeshwar Medical College and Hospital , Solan, Himachal Pradesh, India .
Professor, Department of Anatomy, Government Medical College , Patiala, Punjab, India .
J Clin Diagn Res. 2016 Jun;10(6):AC07-9. doi: 10.7860/JCDR/2016/19506.8062. Epub 2016 Jun 1.
Intercommunication between peripheral nerves deserves special attention in view of their clinical significance. Superficial palmar communication between the median nerve and ulnar nerve is referred to as Berrettini Anastomosis. The presence or absence of this communicating branch varies between individuals. Earlier, incidence of Berretini communication reported varied significantly (4-94%).
The aim of this study was to find out the frequency with which Berretini communication is found in North Indians.
The present study was conducted on 60 upper limbs of 30 cadavers at the Government Medical College, Amritsar. The whole course of the median nerve and the ulnar nerve was exposed. Communicating rami in the hand were identified, cleaned and photographed.
In all the six (10%) variant limbs, the communicating branch originated from lateral common palmar digital branch of ulnar nerve and joined medial common palmar digital branch of median nerve. Single communication with oblique course was seen in all the variants. Further, its ontogeny and clinical implications have been discussed in detail.
The Berretini anastomosis was seen in 10% upper limbs of the present study. Damage to the communicating branch or the severing of the branch might result in sensory loss which may be difficult to diagnose owing to the large number of variations in the origin of the communicating branch. The patterns of sensory impairment may vary depending upon the branch of median and ulnar nerve it is seen connecting.
鉴于周围神经之间的相互连通具有临床意义,值得特别关注。正中神经和尺神经之间的掌浅交通支被称为贝雷蒂尼吻合。该交通支的有无在个体之间存在差异。此前,报道的贝雷蒂尼交通支的发生率差异很大(4%-94%)。
本研究的目的是查明在北印度人中发现贝雷蒂尼交通支的频率。
本研究在阿姆利则政府医学院对30具尸体的60条上肢进行。暴露正中神经和尺神经的全程。识别、清理并拍摄手部的交通支。
在所有6条(10%)变异上肢中,交通支起源于尺神经的掌外侧总指神经,并与正中神经的掌内侧总指神经相连。在所有变异中均可见单一的、走行倾斜的交通支。此外,还详细讨论了其个体发生及临床意义。
在本研究中,10%的上肢可见贝雷蒂尼吻合。交通支受损或切断可能导致感觉丧失,由于交通支起源的大量变异,可能难以诊断。感觉障碍的模式可能因所见连接的正中神经和尺神经分支而异。