摘要
Proximal or middle lesions of the ulnar or median nerves are responsible for extensive loss of hand motor function.This occurs even when the most meticulous microsurgical techniques or nerve grafts are used.Previous studies had proposed that nerve transfer was more effective than nerve grafting for nerve repair.Our hypothesis is that transfer of the posterior interosseous nerve,which contains mainly motor fibers,to the ulnar or median nerve can innervate the intrinsic muscles of hands.The present study sought to investigate the feasibility of reconstruction of the deep branch of the ulnar nerve and the thenar branch of median nerve by transferring the extensor indicis proprius branch of the posterior interosseous nerve obtained from adult cadavers.The results suggested that the extensor indicis proprius branch of the posterior interosseous nerve had approximately similar diameters and number of fascicles and myelinated nerve fibers to those of the deep branch of ulnar nerve and the thenar branch of the median nerve.These confirm the feasibility of extensor indicis proprius branch of posterior interosseous nerve transfer for reconstruction of the deep branch of the ulnar nerve and the thenar branch of median nerve.This procedure could be a novel and effective method for the functional recovery of the intrinsic muscles of hands after ulnar nerve or median nerve injury.
Proximal or middle lesions of the ulnar or median nerves are responsible for extensive loss of hand motor function.This occurs even when the most meticulous microsurgical techniques or nerve grafts are used.Previous studies had proposed that nerve transfer was more effective than nerve grafting for nerve repair.Our hypothesis is that transfer of the posterior interosseous nerve,which contains mainly motor fibers,to the ulnar or median nerve can innervate the intrinsic muscles of hands.The present study sought to investigate the feasibility of reconstruction of the deep branch of the ulnar nerve and the thenar branch of median nerve by transferring the extensor indicis proprius branch of the posterior interosseous nerve obtained from adult cadavers.The results suggested that the extensor indicis proprius branch of the posterior interosseous nerve had approximately similar diameters and number of fascicles and myelinated nerve fibers to those of the deep branch of ulnar nerve and the thenar branch of the median nerve.These confirm the feasibility of extensor indicis proprius branch of posterior interosseous nerve transfer for reconstruction of the deep branch of the ulnar nerve and the thenar branch of median nerve.This procedure could be a novel and effective method for the functional recovery of the intrinsic muscles of hands after ulnar nerve or median nerve injury.
基金
supported by grants from the General Program of Health Department of Jiangsu Province in China,No.H201414
the Science and Technology Development and Planning Program of Suzhou City in China,No.SYS201468
the Science and Technology and Planning Program of Suzhou City in China,No.SS201636
the Second Affiliated Hospital of Soochow University Preponderant Clinic Discipline Group Project in China,No.XKQ2015010
the Science Pre-Research Project of the Second Affiliated Hospital of Soochow University in China,No.SDFEYQN1403
