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Prevalence Martin-Gruberovy anastomózy – elektrofyziologie studie


Authors: E. Ehler 1;  P. Ridzoň 2;  P. Urban 3;  R. Mazanec 4;  H. Matulová 5;  P. Otruba 6;  P. Mandysová 1;  M. Nakládalová 6
Authors‘ workplace: st Faculty of Medicine, Charles University and General University Hospital in Prague 1;  Department of Neurology, Faculty of Health Studies, University of Pardubice and Regional Hospital Pardubice 1;  Department of Neurology, Thomayer Hospital, Prague 2;  Department of Occupational Medicine 3;  Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital Prague 4;  Department of Neurology, Faculty of Medicine, Charles University and University Hospital Hradec Králové 5;  Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc 6
Published in: Cesk Slov Neurol N 2017; 80/113(4): 434-439
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2017434

Overview

Úvod:
Prevalence Martin-Gruberovy anastomózy (MGA), spojky n. medianus a ulnaris na předloktí se uvádí v rozmezí 15– 39 %. Existují tři různé typy MGA, kdy motorická vlákna jsou v oblasti paže a lokte vedena skrze n. medianus a zásobují svaly ruky inervované n. ulnaris (m. abductor digiti minimi, m. interosseus dorsalis primus či m. adductor pollicis).

Soubor a metodika:
V pěti EMG laboratořích bylo unifikovanou technikou vyšetřeno 292 zdravých osob ve věku 20– 67 let, průměr 39,4 let: 166 žen (256 rukou) a 126 mužů (201 rukou), celkem 457 rukou. Byla provedena motorická a senzitivní neurografie n. ulnaris a n. medianus. Pro detekci MGA mělo zásadní význam hodnocení amplitudy CMAP pro n. ulnaris a n. medianus při stimulaci z oblasti lokte a zápěstí.

Výsledky:
V našem souboru 457 vyšetřených rukou jsme na 90 rukou našli 109 výskytů MGA. U 30 rukou se jednalo o MGA-I, u 57 rukou o MGA-II a u 22 rukou o MGA-III. Izolované typy MGA se vyskytly v 73 případech, Na 17 rukou se vyskytla kombinace dvou, ojediněle dokonce všech tří typů MGA současně.

Závěr:
V souboru 292 osob zdravých osob jsme na 457 hodnocených rukou našli MGA v 19,7 %. Nejčastěji se vyskytoval typ MGA-II (12,5 %).

Klíčová slova:
Martin-Gruberova anastomóza –  elektromyografie –  nervus ulnaris –  nervus medianus

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Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

Issue 4

2017 Issue 4

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