RESUMENObjetivo: estudiar la topografía intraneural de la rama profunda del nervio ulnar (RPNU) en el antebrazo distal en vistas a su identificación mediante disección intraneural mínima durante la transferencia del nervio del pronador cuadrado (NPC) a la RPNU. Materiales y Métodos: En 15 antebrazos cadavéricos se fijó el paquete vasculonervioso ulnar a los planos musculares profundos cada un centímetro tomando como referencia el hueso pisiforme. Se disecó en sentido proximal la RPNU bajo microscopio quirúrgico (Olympus OME, 4-20x) y se registró su posición intraneural en base a una división en cuadrantes. Se midió la distancia desde el origen de la rama cutánea dorsal (RCD) del nervio ulnar al pisiforme y se registró su relación intraneural con la RPNU. Resultados: La RPNU se individualizó hasta 69mm (41-94) proximal al hueso pisiforme, ubicándose en el cuadrante posteromedial del nervio ulnar en el 78% (67-87), el 93% (92-93) y el 100% de los casos entre los 0-2, 3-6 y 7-9 centímetros, respectivamente. La distancia pisiforme-RCD fue de 63mm (52-83). En 11 miembros la disección de la RPNU se extendió proximalmente al origen de la RCD, ubicándose siempre entre esta última y la rama superficial del nervio ulnar. Conclusiones: La topografía intraneural de la RPNU en el sitio óptimo para su sección en vistas a su anastomosis con el NPC es predecible en la mayoría de los casos, lo que confirma la viabilidad de su identificación precisa mediante disección intraneural mínima.Palabras clave: transferencia nerviosa; interóseo anterior; ulnar; neurocirugía; rama profunda del nervio ulnar. ABSTRACTObjective: to assess the intraneural anatomy of the deep branch of the ulnar nerve (DBUN) in the distal forearm in reference to its identification by means of minimal intraneural dissection during pronator quadratus nerve to DBUN transfers. Materials and Methods: In 15 cadaveric forearms the ulnar neurovascular bundle was identified and attached to the subjacent muscles every one centimeter. Pisiform bone was used as reference. Intraneural proximal dissection of the deep branch of the ulnar nerve was performed under magnification (Olympus OME, 4-20x) and its intraneural position was registered using a quadrants scheme. Distance from pisiform to the origin of the dorsal cutaneous branch of the ulnar nerve (DCB) was measured and its intraneural position relative to DBUN was identified. Results: The DBUN could be identified up to 69mm (41-94) proximal to the pisiform and occupied the posteromedial quadrant of the ulnar nerve in 78% (67-87), 93% (92-93) and 100% of the cases in the 0-2, 3-6 and 7-9cm ranges, respectively. Distance from pisiform bone to the origin of the DCB was 63mm (52-83). The DBUN could be identified proximal to the origin of the DCB in 11 forearms, being located between the latter and the superficial branch of the ulnar nerve in all this cases. Conclusions: Intraneural topography of the DBUN in the most appropriate site for its identification during its anastomosis to the PQN is predictable in the majority of ca...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.