Presence of Martin-Gruber Anastomosis among a Cohort of Mexican Origin; a Corpse Dissection Study.

Abstract

Background: At the forearm level, Martin-Gruber anastomosis is described as the most common anatomic variation. Early recognition of this anastomosis in patients with peripheral nerve lesions and preserved function of the hand musculature lowers the rate of misdiagnosis and prevents unnecessary treatment approaches. We aimed to determine the prevalence and characteristics of Martin-Gruber anastomosis in a Mexican cohort and discuss its impact on clinical diagnostics and approach.

Methods: We conducted a cross-sectional dissection study on 40 inert anatomical models at the National Forensic Sciences Institute in Mexico City. Each model was dissected to trace and measure Martin-Gruber anastomoses from the median nerve to the ulnar nerve. Measurements were recorded using a digital Vernier caliper, and the presence of anastomosis, its length, nerve of origin, and side were analyzed. Chi-square tests evaluated the association between the presence of anastomoses and sex, and nerve origin and arm side.

Results: Martin-Gruber anastomosis was found in 47.5% of the specimens, with bilateral anastomoses in 11 and unilateral in eight. The majority of anastomoses (62.5%) originated from the left arm. There was no significant association between the presence of anastomosis and sex (P=0.093) or between the nerve origin and arm side (P=0.809).

Conclusion: The high prevalence of Martin-Gruber anastomosis in this study highlights its clinical importance, particularly in preventing misdiagnoses of ulnar nerve injuries and unnecessary surgical interventions. Anatomical variations like Martin-Gruber anastomosis should be considered in clinical assessments of peripheral nerve injuries to enhance diagnostic accuracy and treatment outcomes.