Posts Tagged ‘neurotization’
Background: In injuries of the lower brachial plexus, finger flexion can be restored by nerve or tendon transfer. However, there is no technique that can guarantee good recovery of finger and thumb extension.
Objective: To determine the spinal nerve origins of the muscular branches of the radial nerve and identify potential intraplexus donor nerves for neurotization of the posterior interosseous nerve in patients with lower brachial plexus injuries.
Methods: An intraoperative electrophysiological study was carried out during 16 contralateral C7 nerve transfers. The CMAP (compound muscle action potential) of each muscle innervated by the radial nerve was recorded while the C5-T1 nerves were individually stimulated.
Background: In tetraplegics, thumb and finger motion traditionally has been reconstructed via orthopedic procedures. Although rarely employed, nerve transfers are a viable method for reconstruction in tetraplegia.
Objective: To investigate the anatomical feasibility of transferring the distal branch of the extensor carpi radialis brevis (ECRB) to the flexor pollicis longus (FPL) nerve, and to report our first clinical case.
Methods: We studied the motor branch of the ECRB and FPL in 14 cadaveric upper limbs. Subsequently, one 24-year old tetraplegic male with preserved motion in his shoulder, elbow, wrist and finger extension, but paralysis of thumb and finger flexion, was operated upon. Seven months after trauma, we transferred the brachialis muscle with a tendon graft to the flexor digitorum profundus. The distal nerve of the ECRB was transferred to the FPL nerve.