20.500.12556/RUL-188658 Prevalenca Martin-Gruberjeve anastomoze diplomsko delo Prevalence of the Martin-Gruber anastomosis diploma work Uvod: Živčna povezava oziroma anastomoza med medianim in ulnarnim živcem je anomalija, ki se lahko pojavi na različnih mestih zgornjega uda. Najpogosteje se pojavi v podlakti kot Martin-Gruberjeva anastomoza. Svetovna prevalenca anastomoze je ocenjena na 19,5 %. Čeprav je Martin-Gruberjeva anastomoza asimptomatska in se običajno ugotovi med elektrofiziološkim pregledom perifernih živcev podlakti, lahko vodi do napačne interpretacije različnih poškodb, zato je njeno prepoznavanje ključno. Namen: Namen diplomskega dela je opisati anatomske značilnosti Martin Gruberjeve anastomoze ter pridobiti podatek o njeni prevalenci pri preiskovanem vzorcu ter preučiti morebitno korelacijo med stranjo zgornjega uda in biološkim spolom. Metode dela: V raziskavo smo vključili 80 prostovoljcev različnih starosti in obeh spolov, pri čemer smo izključili preiskovance z boleznimi perifernega živčevja. Preiskovancem smo obojestransko izmerili amplitudo valov M z draženjem medianega in ulnarnega živca nad zapestjem in v predelu komolca ter odjemanjem nad mišicami abduktorjem mezinca, prvo dorzalno interosalno mišico in kratkim abduktorjem palca. Na podlagi dobljenih rezultatov smo ugotavljali prisotnost oziroma odsotnost Martin-Gruberjeve anastomoze. Rezultati: Pri 39 preiskovancih smo potrdili prisotnost anastomoze, kar predstavlja prevalenco 48,8 %. Najpogostejša je bila anastomoza tipa II (59,0 %), sledili sta tip I (20,5 %) in tip IV (20,5 %), medtem ko izoliranega tipa III nismo ugotovili. Statistično značilne povezave med prisotnostjo anastomoze in stranjo zgornjega uda nismo ugotovili (p = 0,79). Povezava med biološkim spolom in prisotnostjo anastomoze prav tako ni bila statistično značilna (p = 0,76). Razprava in zaključek: Rezultati raziskave kažejo, da je Martin-Gruberjeva anastomoza v populaciji verjetno pogostejša, kot se pogosto predvideva, zato bi morali zdravstveni delavci pri diagnostiki poškodb in utesnitvenih nevropatij zgornjega uda vedno upoštevati možnost prisotnosti te anomalije. Neprepoznana anastomoza lahko vpliva na interpretacijo rezultatov elektrofizioloških preiskav ter posledično privede do diagnostičnih napak, zato je njeno prepoznavanje ključnega pomena. Za natančnejšo oceno prevalence bi bile v prihodnje smiselne raziskave na večjih vzorcih ter uporaba enotnih diagnostičnih kriterijev, kar bi omogočilo boljšo primerljivost rezultatov med posameznimi raziskavami. Introduction: A nerve connection, or anastomosis, between the median and ulnar nerves is an anatomical variation that may occur at various sites in the upper limb. It most commonly occurs in the forearm as Martin-Gruber anastomosis. The global prevalence of Martin-Gruber anastomosis has been estimated at 19,5 %. Although Martin-Gruber anastomosis is asymptomatic and is usually identified during electrophysiological examination of the peripheral nerves of the forearm, it may lead to misinterpretation of various injuries, therefore, its recognition is of great clinical importance. Purpose: The aim of this diploma thesis was to describe the anatomical characteristics of Martin-Gruber anastomosis, determine its prevalence in the study sample, and investigate possible correlation between the presence of the anastomosis and the side of the upper limb and biological sex of the subjects. Methods: The study included 80 volunteers of different ages and both sexes. Subjects with peripheral nerve disorders were excluded. Compound muscle action potential amplitudes were recorded bilaterally following stimulation of the median and ulnar nerves at the wrist and around-elbow sites, with recordings obtained from the abductor digiti minimi, first dorsal interosseus and abductor pollicis brevis muscles. The presence or absence of Martin-Gruber anastomosis was determined based on the obtained electrophysiological findings. Results: Martin-Gruber anastomosis was identified in 39 subjects, corresponding to a prevalence of 48,8 %. Type II anastomosis was the most common subtype (59,0 %), followed by type I (20,5 %) and type IV (20,5 %), while type III was not detected. No statistical significance was found between the presence of the anastomosis and the side of the upper limb (p = 0,79). Likewise, no statistical significance was observed between the presence of the anastomosis and biological sex (p = 0,76). Discussion and conclusion: The findings suggest that Martin-Gruber anastomosis may be more common than generally assumed. Therefore, healthcare professionals should consider the possibility of this anatomical variation when diagnosing upper limb injuries and entrapment neuropathies. Failure to recognize Martin-Gruber anastomosis may affect the interpretation of electrophysiological findings and lead to diagnostic errors. Future studies involving larger samples and standardized diagnostic criteria are needed to provide a more accurate estimate of the prevalence of Martin-Gruber anastomosis and to cross-study comparison. diplomska dela fizioterapija Martin-Gruberjeva anastomoza anatomska odstopanja prevalenca val M diploma theses physiotherapy Martin-Gruber anastomosis anatomical variations prevalence compound muscle action potential true false false [D. Koša] Slovenski jezik Angleški jezik Diplomsko delo/naloga 2026-09-25 07:46:10 2026-09-25 07:46:15 2026-09-26 04:31:26 0000-00-00 00:00:00 2026 0 Ljubljana 0 Ljubljana 25 str., [3] str. pril. 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 615.8 165905 292473091 63454.pdf 63454.pdf 1 446DD645FE2A04EE711CADC1BB46F7E1 b1701384743c8e35630cdc18ce7568c23f02206a77cb22ad3bd28dd96ed826a0 588d4e8a-b8a4-11f1-8bc5-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=248949 Zdravstvena fakulteta 0 0 0