A Cadaver Study of Median-to-Radial Nerve Transfer for Radial Nerve Injuries

作者:Sukegawa Koji*; Suzuki Takane; Ogawa Yasufumi; Kobayashi Tomoko; Matsuura Yusuke; Kuniyoshi Kazuki
来源:Journal of Hand Surgery-American Volume, 2016, 41(1): 20-26.
DOI:10.1016/j.jhsa.2015.10.015

摘要

Purpose To assess the anatomic feasibility of a median-to-radial nerve transfer in cadaver limbs and to quantify the number of axons present in the cut ends of the involved donor and recipient nerves. Methods Ten fresh frozen cadaveric upper limbs were dissected. We investigated whether the flexor carpi radialis (FCR) branch/flexor digitorum superficialis (FDS) branch (donor nerve) reached the posterior interosseous nerve (PIN)/extensor carpi radialis brevis (ECRB) branch (recipient nerve) without tension. We also investigated the length of the transected supinator fascia for FCR-posterior interosseous nerve transfer and the FDS-ECRB positional relationship using the epicondyle line and the midline of the forearm as axes. The findings were used for these 2 types of nerve transfer with evaluation closer to the target muscles. The distance between the point at which the FDS and ECRB branches met and the point at which the ECRB branch entered the muscle was measured. After nerve coaptation, the axon number was determined by histological evaluation. Results In all limbs, the FCR and FDS branches reached the PIN and the ECRB branch without tension. The transected supinator fascia was 17 (3-25) mm long. The distance between the FDS and ECRB branches was 48 (23-65) mm distal to the epicondyle line and approximately 23 (18-27) mm radial to the midline of the forearm. The distance between the point at which the FDS and ECRB branches met and the point at which the ECRB branch entered the muscle was 27 (17-40) mm. The mean axon numbers were FCR, 1501 (932-3022); PIN, 5162 (4325-7732); FDS, 885 (558-962); and ECRB, 548 (433-723). Conclusions The FCR branch could be transferred to the PIN branch and the FDS to the ECRB branch in all limbs without tension.

  • 出版日期2016-1