Median to radial nerve transfer for treatment of radial nerve palsy
Median to radial nerve transfer for treatment of radial nerve palsy
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DOI：
10.3171/jns-07/09/0666
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发表时间：
2007-09-01
影响因子：
4.1
通讯作者：
Tung, Thomas H.
中科院分区：
文献类型：
--
作者：
Mackinnon, Susan E.;Roque, Brandon;Tung, Thomas H.
本研究的目的是报告一种手术技术的神经转移，以恢复桡神经功能完全瘫痪后，由于近端损伤的桡神经。作者报告了1例患者，将前臂近端正中神经多余或消耗性运动支直接转移至桡侧腕短伸肌和桡神经骨间后支。评估包括腕关节和手指伸展的恢复程度，以及正中神经功能（包括捏力和握力）。随访18个月。手指和手腕伸展几乎完全恢复，力量为4/5级。术后捏和握力得到改善。无正中神经相关的运动或感觉障碍，患者对功能恢复程度非常满意，转移多余的正中神经协同运动分支可以成功地重新支配手指和腕伸肌，恢复桡神经功能。这种正中至桡神经转移为治疗桡神经麻痹提供了神经修复、移植或肌腱转移的替代方案。
The purpose of this study is to report a surgical technique of nerve transfer to restore radial nerve function after a complete palsy due to a proximal injury to the radial nerve. The authors report the case of a patient who underwent direct nerve transfer of redundant or expendable motor branches of the median nerve in the proximal forearm to the extensor carpi radialis brevis and the posterior interosseous branches of the radial nerve. Assessment included degree of recovery of wrist and finger extension, and median nerve function including pinch and grip strength.Clinical evidence of reinnervation was noted at 6 months postoperatively. The follow-up period was 18 months. Recovery of finger and wrist extension was almost complete with Grade 4/5 strength. Pinch and grip strength were improved postoperatively. No motor or sensory deficits related to the median nerve were noted, and the patient is very satisfied with her degree of functional restoration.Transfer of redundant synergistic motor branches of the median nerve can successfully reinnervate the finger and wrist extensor muscles to restore radial nerve function. This median to radial nerve transfer offers an alternative to nerve repair, graft, or tendon transfer for the treatment of radial nerve palsy.