Protective Coverage of the Median Nerve Using Fascial, Fasciocutaneous or Island Flaps
| Autor: | R. Luchetti, M. Riccio, T. Fairplay, I. Papini Zorli |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Reoperation Distant flap Microsurgery medicine.medical_specialty medicine.medical_treatment Tissue Adhesions Island Flaps Return to work Surgical Flaps Cicatrix Postoperative Complications Forearm Recurrence medicine.artery medicine Humans Orthopedics and Sports Medicine Radial artery Aged business.industry Mean value Middle Aged Carpal Tunnel Syndrome Median nerve Median Nerve Surgery body regions medicine.anatomical_structure Radial Artery Female business Follow-Up Studies |
| Zdroj: | Handchirurgie · Mikrochirurgie · Plastische Chirurgie. 38:317-330 |
| ISSN: | 1439-3980 0722-1819 |
| DOI: | 10.1055/s-2006-924551 |
| Popis: | The aim of the study is to present our experience with fascial or fasciocutaneous pedicle and island flaps in the treatment of recurrences of CTS with and without median nerve lesions.From 1987 to 2006 we have operated on 25 patients (17 women and 8 men, ages ranging from 38 to 76 years with a mean age of 55 years) due to a recurrence of CTS. All the patients required nerve coverage using a local or distant flap. There were 19 hypothenar fat flaps; two forearm radial artery flaps, a forearm ulnar artery flap, an ulnar fascial-fat flap and a posterior interosseous flap. Patients were clinically and instrumentally evaluated before the operation. Assessments of the evaluation parameters were classified in excellent, good, fair and poor according to clinical and return to work criteria.Patients were evaluated after a mean follow-up of 51 months (12 to 168 months). The pain evaluation showed an improvement passing from a mean value of 9 to 4. The best results were for those patients in whom the median nerve was undamaged (mean value of 1). Eleven patients obtained excellent results; good results were obtained in twelve cases; two patients demonstrated fair results due to partial median nerve injury. In these cases, a hypothenar fat flap and an ulnar fascial-fat flap were used, respectively.Protective coverage of the median nerve by using fascial or fasciocutaneous flaps after failure of CTR and/or unsuccessful re-operations is a good solution to furnish to the median nerve a gliding tissue to avoid adherences with the surrounding tissue of previous surgery. The protection of the nerve can reduce painful symptoms even if it does not permit a return to a painless condition. However, the clinical results in terms of median nerve functional recovery cannot be predicted: if the median nerve is damaged, protective coverage of it by flaps cannot give a favourable result in terms of recovery of both sensory and motor deficits. |
| Databáze: | OpenAIRE |
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