Abstract Details

Title Increased Incidence of Martin Gruber Anastomosis in Individuals with Ulnar Neuropathy

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 12-039

Objective The objective is to assess for the vulnerability of ulnar neuropathy at the elbow in those who have Martin Gruber Anastomosis in the forearm.

Background Ulnar neuropathy is the second most commonly encountered entrapment neuropathy of the upper extremity, most frequently located around the elbow due to the superficial location of the nerve. A commonly identified anomaly on Nerve Conduction Study is the Martin Gruber Anastomosis (MGA), where a normal variant motor branch of the median nerve joins the ulnar nerve, most commonly in the forearm. This anomalous connection between the median and ulnar nerve is thought to deliver more robust motor ulnar nerve fibers distally than found at the elbow, predisposing this region to nerve damage.

Design/Methods Retrospective data was collected from the George Washington University – Medical Faculty Associates database. 144 patients with ulnar neuropathy at the elbow were identified, and their age, BMI, gender, comorbidity of diabetes, and presence or absence of MGA was recorded.

Results Of the 144 patients with ulnar neuropathy at the elbow, 105 (73%) were found to have a MGA, of which 81 (77%) had a MGA in the forearm, whereas 24 (23%) had a MGA in the proximal arm.

Conclusions This study shows that MGA is a challenging co-existing anomaly frequently encountered in cases of ulnar neuropathy at the elbow, and should be investigated in all cases of ulnar neuropathy. Our data highly suggests that the presence of MGA may increase the risk of ulnar neuropathy at the elbow.

Authors/Disclosures
Shreya Gandhy, DO (Medstar Georgetown) PRESENTER	Dr. Gandhy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amylyx.
Mary Russo, RNCT (GW Medical Faculty Assoc)	No disclosure on file
Faranak Najibi, MD (Advocate Medical Group, Advocate Health Care)	No disclosure on file
Elham Bayat, MD (George Washington University/MFA)	Dr. Bayat has nothing to disclose.

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