Electrodiagnostic Evidence of Berrettini Anastomosis

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Abstract

Purpose:

Cadaveric palmar dissections reveal an ulnar sensory crossover (Berrettini anastomosis) to the third common palmar nerve so frequently that this crossover is considered a normal part of the anatomy. No literature has documented electrophysiologic evidence of the Berrettini anastomosis (BA). Presentation of third digit ulnar sensory crossover waveforms.

Methods:

Retrospective chart review case series. Clinical office. Nerve conduction waveforms and data.

Results:

Ulnar stimulation sensory crossover waveforms to digit three consistent with BA are presented.

Conclusions:

Third digit BA is measurable in routine electrodiagnostic nerve conduction study in some patients. The observed BA latency is the same and the amplitude is smaller (25% to 33%) than the ulnar sensory response. The clinical significance of the BA sensory response is unclear. The presence of a BA in severe carpal tunnel syndrome may give a small amplitude normal latency sensory response that could be misinterpreted and lead to a false negative result.

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