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Introduction: Intercommunication between peripheral nerves deserves special attention in view of their clinical significance. Superficial palmar communication between the median nerve and ulnar nerve is referred to as Berrettini Anastomosis. The presence or absence of this communicating branch varies between individuals. Earlier, incidence of Berretini communication reported varied significantly (4-94%). Aim: The aim of this study was to find out the frequency with which Berretini communication is found in North Indians. Materials and Methods: The present study was conducted on 60 upper limbs of 30 cadavers at the Government Medical College, Amritsar. The whole course of the median nerve and the ulnar nerve was exposed. Communicating rami in the hand were identified, cleaned and photographed. Results: In all the six (10%) variant limbs, the communicating branch originated from lateral common palmar digital branch of ulnar nerve and joined medial common palmar digital branch of median nerve. Single communication with oblique course was seen in all the variants. Further, its ontogeny and clinical implications have been discussed in detail. Conclusion: The Berretini anastomosis was seen in 10% upper limbs of the present study. Damage to the communicating branch or the severing of the branch might result in sensory loss which may be difficult to diagnose owing to the large number of variations in the origin of the communicating branch. The patterns of sensory impairment may vary depending upon the branch of median and ulnar nerve it is seen connecting.

Introduction Communications between peripheral nerves are important in the light of the fact that these are responsible for a myriad of clinical symptoms. Communication between the median nerve and ulnar nerve (Martin-Gruber anastomosis) is a frequent finding observed anatomically in 10%-30.6% subjects and physiologically in 5-40%. It may lead to exacerbated or attenuated clinical symptoms. Aims & objectives To find out the incidence of Martin-Gruber anastomosis in North Indian population by cadaveric dissection. Materials and methods The material comprised of 60 upper limbs belonging to 30 cadavers (M:F::28:2) which were dissected to find out incidence of Martin-Gruber anastomosis. Results Martin-Gruber anastomosis was encountered in 7(11.6%) limbs of the present study. It was seen more frequently unilaterally (16.6%) than bilaterally (3.3%) and only in males. Classification of limbs into various patterns and types was done. Further its ontogeny, phylogeny, genetic inheritance and clinical implications are discussed in detail. Conclusion To conclude, in North Indian population, the Martin-Gruber anastomosis is encountered in 11.6% limbs.

Introduction: During evolution from lower animals to higher animals the hand has undergone a great revolution. Lumbricals of the hand produce flexion at metacarpophalangeal joint and extension at the interphalangeal joint thus helping in performance of precise work. Material & Methods: The present study was conducted on 60 upper limbs of 30 well embalmed adult human cadavers at the Government Medical College, Amritsar. The whole course of the median and ulnar nerve and its branches in hand was traced. Aim: Aim was to study the nerve supply of different lumbricals of hand. Results: In the present study, variations from the normal pattern were found in the innervation of lumbricals. Besides the first two lumbricals, median nerve was innervating the third lumbrical in 3(5%) hands. Second lumbrical was supplied by two branches from median nerve in 2(3.3%) hands. We also found berretini communications between median and ulnar nerves in 6(10%) hands but it has been described earlier by the same authors in a different article. Clinical Significance: The variation in innervation of lumbricals in hand and their incidence will aid the surgeon in avoiding iatrogenic complications and improve the success rate of surgeries performed on hand. Keywords: Hand, Lumbricals, Median nerve, Ulnar nerve, Innervation

Neurovascular variations in the upper limb are common and they are well documented. An accurate knowledge of the normal and the variant anatomy of the median nerve and the median artery are important for clinical procedures and for vascular surgeries. The persistant median artery is one such anomaly which was seen in 6.6% (4) of the 60 upper limbs which were dissected in the present study, it being bilateral in one cadaver.The present study was conducted on 60 upper limbs of 30 cadavers at the Government Medical College, Amritsar, India. The whole course of the median nerve and the persistant median artery was exposed.In all the 4 variant limbs, the persistent median artery originated from the anterior interrosseous artery and terminated in the incomplete mediano- ulnar type of the superficial palmar arch. In three upper limbs, the persistant median artery simply accompanied the median nerve upto the palm. But in the left upper limb of the cadaver with the bilateral variation, the artery penetrated and divided the nerve into two halves which joined to form a neural loop around the artery. Thereafter, the nerve and the artery followed the same course upto the palm. Such a penetration of the median nerve by the persistent median artery is extremely rare. Further, its ontogeny and clinical implications have been discussed in detail.