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Anastomosis Between Ulnar And Radial Nerve: A Cadaveric Study

Background: Brachial plexus variations are not rare. Variations in its terminal branches in the arm or forearm are frequently reported. Communications between branches of the brachial plexus are also not uncommon findings; however there is very little mention of communication between the radial and ulnar nerves in the literature. In view of this significance is performed this study with the purpose to determine any communications of radial nerve with neighboring peripheral nerves at level of axilla, arm, forearm.

Methods and Findings: A total of 17 cadavers with different age groups were used for this study. The upper limbs region (34 sides) were dissected carefully and photographed in the Morphology Laboratory at the University of Pamplona. Of the 34 upper limbs studied 33 showed normal morphology, the course and branching patterns of the nerves was normal (97.06%). In 1 specimen in the left forearm (2.94%), the radial and ulnar nerves were dissected and communicating branches were observed originating near the upper third in the posterior aspect of the forearm traveling from the ulnar to the radial nerve. The communicating branch was approximately 5.84 cm long and 1.73 mm in diameter. This anastomotic branch is an unusual anastomosis, no described in the literature between radial and ulnar nerve in forearm. Knowledge on the variant pattern of peripheral nerves is imperative not only for the surgeons, but also for the radiologists during image technology and MRI interpretations and for the anesthesiologists before administering anesthetic agents thus in diagnostic approaches.  

Conclusions: Lack of understanding of these variations can also confound the assessment of the severity of nerve injury as well as recovery. Awareness of such anatomical variations is very important in order to proper diagnosis of sensorimotor symptoms.

from International Archives of Medicine
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