Innervation Anomalies and Interneural Anastomoses: Is There Clinical Relevance or Not?

Abstract

Failed block could be one of the adverse results of the conductive anaesthesia. There are situations, when in seemingly perfect technique of the block, properly chosen drug, dosage, adjuvant – the block is not achieved (it does not occur or is incomplete or so-called “mosaic block” occurs). It is necessary to remember about atypical or abnormal nerves branching, possible interneural anastomoses, when looking for the possible cause of it. Information about most common types of interneural anastomosis of arm’s and leg’s long nerves is presented in this article. Knowledge of possible abnormal neural innervation can provide an understanding of inefficacy of some simple blocks, decrease amount of mistakes in data interpretation, that was obtained during electroneuromyographic (ENMG) investigations, improve understanding of clinical pattern in the peripheral nerve injuries, that form anastomosis.

Keywords

• interneural anastomosis
• innervation anomalies
• conductive anaesthesia
• electroneuromyography