Ann Rehabil Med.  2012 Oct;36(5):719-723.

Ulnar Neuropathy Around the Mid-Arm Combined with Martin-Gruber Anastomosis

• Kim BJ
• Kim DH

Abstract

This study reports a rare case of ulnar neuropathy around the arm with Martin-Gruber anastomosis of a moderate conduction block in the forearm segment and a severe conduction block in the arm segment. Inching tests and ultrasonography showed a lesion between 12 and 14 cm from the medial epicondyle. It is concluded that axilla stimulation may provide diagnostic clues, and inching tests and ultrasonography may be helpful for localizing a lesion.

Keyword

Martin-Gruber anastomosis; Ulnar nerve; Ultrasonography

MeSH Terms

Arm
Axilla
Forearm
Ulnar Nerve
Ulnar Neuropathies

Figure

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  Fig. 1 Ulnar motor segmental study findings for the left ulnar motor nerve showing a mild to moderate pseudo-conduction block in the forearm segment and a severe conduction block in the arm segment: (A) abductor digiti minimi (ADM) recording; (B) first dorsal interosseous (FDI) recording. Stim: stimulation sites, ME-3: 3 cm distal to the medial epicondyle (ME), ME+7: 7 cm proximal to the ME, ME+17: 17 cm proximal to the ME.

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  Fig. 2 Recording of the median compound muscle action potential of the first dorsal interosseous (FDI) muscle, showing increased amplitude for elbow stimulation on both sides. Stim: stimulation sites, Amp: amplitude.

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  Fig. 3 Ultrasonograms showing mild compression (small arrows, 0.11 cm2) of the ulnar nerve at 12 cm proximal to the medial epicondyle (ME+12), and mild swelling (0.18 cm2) 13 cm proximal to the medial epicondyle (ME+13). (A) longitudinal section, (B) cross-section at ME+12, (C) cross-section at ME+13.

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