[Anatomical cartography of the radial nerve at the elbow level for intraradial nerve transfers for finger extension reconstruction in spastic upper limb - A cadaveric study].

Autor: Maincourt P; Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Brest, hôpital de la Cavale-Blanche, Brest, France., Ramiere J; Service de chirurgie orthopédique, HIA Clermont Tonnerre Brest, rue Colonel-Fontferrier, 29240 Brest cedex, France., Seizeur R; Service de neurochirurgie, CHRU de Brest, hôpital de la Cavale-Blanche, Brest, France; Laboratoire d'anatomie de la faculté de médecine de Brest, université de Bretagne Occidentale, Brest, France., Hu W; Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Brest, hôpital de la Cavale-Blanche, Brest, France., Perruisseau-Carrier A; Service de chirurgie de la main et des brûlés, CHU de Grenoble Alpes, hôpital Michallon, Grenoble, France. Electronic address: aperruisseaucarrier@chu-grenoble.fr.
Jazyk: francouzština
Zdroj: Annales de chirurgie plastique et esthetique [Ann Chir Plast Esthet] 2024 Sep; Vol. 69 (5), pp. 343-354. Date of Electronic Publication: 2024 Aug 05.
DOI: 10.1016/j.anplas.2024.07.005
Abstrakt: Introduction: Upper limb spasticity is a surgical challenge, both in diminishing agonists spasticity and reconstructing antagonist function. Brachioradialis (BR) is often involved in elbow flexors spasticity. Finger extension is often impaired in spastic patients. This study aims to demonstrate the feasibility of BR motor branch to posterior interosseous nerve (PIN) during BR selective neurectomies, and to describe fascicles topography inside the radial nerve to facilitate PIN dissection.
Material and Method: Ten upper limbs from 10 fresh frozen anatomical specimens were dissected. Motor branches to the BR, wrist extensors, supinator, PIN and radial sensory branch were identified. BR to PIN transfer was realized and its feasibility was studies (donor length, tensionless suture).
Results: BR to PIN transfer was achievable in 9 out of 10 cases. The position of the sensory branch of the radial nerve was inferior or medial in all cases. The position of the PIN was lateral in 90% of the cases.
Conclusion: BR to PIN nerve transfer is achievable in most cases (90%). The lateral topography of the PIN and the inferomedial topography of the sensory branch in most cases allows for an easier intraoperative finding of the PIN when stimulation is not possible.
Level: IV, feasibility study.
(Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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