Marinacci Communication With Recovery of the Thumb, Finger, and Wrist Flexion After a High Median Nerve Injury: A Case Report and Review of Literature.

Abstract

The Marinacci communication (MC) contains fibers from the ulnar to the median nerve in the forearm in a proximal to distal fashion. This rare ulnar-to-median nerve anomalous communication has mainly been reported as an incidental finding. In the case presented here, this anatomical variationled torapid recovery of the thumb, finger, and wrist flexion following a high above elbow complete median nerve injury. A 17-year-old female was involved in an all-terrain vehicle rollover accident and had her right elbow crushed. She presented with no motor or sensory function in the forearm and hand, with a weak monophasic radial artery signal and no palpable pulse. She underwent surgery and was treated with 12 cm interposition cable sural nerve grafting. Although recovery after a high median nerve injury is often prolonged and incomplete, the MC resulted in the recovery of sensation and motor function through muscles typically innervated by the median nerve, following a complete high median nerve injury. In the presence of anomalous recovery following median nerve injury or unusual electrophysiological findings, an MC should be considered as a cause.