Distal Sensory Nerve Transfers in Lower-Type Injuries of the Brachial Plexus

Bertelli, Jayme Augusto

doi:10.1016/j.jhsa.2012.02.047

Cited by 33 publications

(37 citation statements)

References 24 publications

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“…Even minor repetitive traumas can result in lesions, infections and, in extreme cases, loss of tissue of the hand/fingers 17,18 . Sensory reconstruction with intercostal and supraclavicular nerves can provide only a limited recovery of sensibility in the hand 3,4,15,19,20,21,22,23,24 .…”

Section: Discussionmentioning

confidence: 99%

The intercostobrachial nerve as a sensory donor for hand reinnervation in brachial plexus reconstruction is a feasible technique and may be useful for restoring sensation

Foroni

Siqueira

Martins

et al. 2017

Arq. Neuro-Psiquiatr.

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ARTICLEThe intercostobrachial nerve as a sensory donor for hand reinnervation in brachial plexus reconstruction is a feasible technique and may be useful for restoring sensation O uso do nervo intercostobraquial como doador na restauração cirúrgica da sensibilidade da mão em lesões do plexo braquial é uma técnica anatomicamente viável e pode ser útil para a recuperação sensitiva ABSTRACTObjective: Few donors are available for restoration of sensibility in patients with complete brachial plexus injuries. The objective of our study was to evaluate the anatomical feasibility of using the intercostobrachial nerve (ICBN) as an axon donor to the lateral cord contribution to the median nerve (LCMN). Methods: Thirty cadavers were dissected. Data of the ICBN and the LCMN were collected, including diameters, branches and distances. Results: The diameters of the ICBN and the LCMN at their point of coaptation were 2.7mm and 3.7mm, respectively. The ICBN originated as a single trunk in 93.3% of the specimens and bifurcated in 73.3%. The distance between the ICBN origin and its point of coaptation to the LCMN was 54mm. All ICBNs had enough extension to reach the LCMN. Conclusion: Transfer of the ICBN to the LCMN is anatomically feasible and may be useful for restoring sensation in patients with complete brachial plexus injuries.Keywords: brachial plexus; intercostal nerves; median nerve; nerve transfer; sensation. RESUMOObjetivo: Poucos doadores estão disponíveis para a restauração da sensibilidade em pacientes com lesões completas do plexo braquial (LCPB). O objetivo deste estudo foi avaliar a viabilidade anatômica do uso do nervo intercostobraquial (NICB) como doador de axônios para a contribuição do cordão lateral para o nervo mediano (CLNM). Métodos: Trinta cadáveres foram dissecados. Os dados do NICB e do CLNM foram coletados: diâmetros, ramos e distâncias. Resultados: Os diâmetros do NICB e da CLNM no ponto de coaptação foram 2,7mm e 3,7mm, respectivamente. O NICB originou-se como um único tronco em 93,3% dos espécimes e bifurcou-se em 73,3%. A distância entre a origem do NICB e seu ponto de coaptação com a CLNM foi de 54mm. Todos os NICBs tiveram extensão suficiente para alcançar a CLNM. Conclusão: A transferência do NICB para a CLNM é anatomicamente viável e pode ser útil para restaurar a sensibilidade em pacientes com LCPB.Palavras-chave: plexo braquial; nervos intercostais; nervo mediano; transferência de nervo; sensação.

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Section: Discussionmentioning

confidence: 99%

The intercostobrachial nerve as a sensory donor for hand reinnervation in brachial plexus reconstruction is a feasible technique and may be useful for restoring sensation

Foroni

Siqueira

Martins

et al. 2017

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…Although axons can travel in the epineurial space of rabbit nerves [18], in humans the epineurial window is essential to achieve axonal regeneration [68]. Sensory axons will spontaneously sprout from the healthy into the injured nerve, providing a kind of protective sensation, although it is never fully normal [11,65,66]. Meanwhile, donor nerve motor axons need an injury (crush or axotomy) to sprout inside an end-to-side coapted damaged nerve [66,69].…”

Section: End-to-end Anastomosismentioning

confidence: 99%

“…tip of the thumb and index fingers) [33,49,51,61,65]. They also help with neuropathic pain control [13,29,49,156].…”

Section: Nerve Transfers For Upper Limb Sensation Recoverymentioning

confidence: 99%

“…The donors are the nerves supplying less essential areas like the third web space (MN branch) the forth web space (UN branch), the dorsal sensory branch of the UN and the radial sensory nerve (RSN) [22,29,49,50,65,157,158]. Ducic et al [159] in 2006 recovered the sensation of the thumb and index fingers using the radial nerve branches as donors.…”

Section: Nerve Transfers For Upper Limb Sensation Recoverymentioning

confidence: 99%

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Nerve Transfers in the Treatment of Peripheral Nerve Injuries

Vanaclocha‐Vanaclocha¹,

Ortiz-Criado²,

NievesSáiz-Sapena³

et al. 2017

Peripheral Nerve Regeneration - From Surgery to New Therapeutic Approaches Including Biomaterials and Cell-Based Therapies Deve

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Successful re-innervation of proximal limb peripheral nerve injuries is rare. Axons regenerate at ~1 mm/day, reaching hand muscles by 24 months, finding them atrophied and fibrosed. Peripheral nerve injury repair is often delayed waiting for spontaneous recovery. This waiting time should not be longer than 6 months as after 18 months reinnervation will not achieve effective muscular function. When spontaneous recovery is impossible, referral too late or damage too severe, other options like a transfer from a nearby healthy nerve to the injured one must be considered. They are very successful, and the deficit in the donor site is usually minimal. The most common nerve transfers are a branch of the spinal nerve to the trapezius muscle to the suprascapular nerve, a branch of the long head of the triceps to the axillary nerve, a fascicle of the ulnar nerve to the motor branch of the biceps muscle, two branches of the median nerve to the posterior interosseous nerve and the anterior interosseous nerve to the ulnar nerve. There are many more options that can suit particular cases. Introduced in brachial plexus injury repair, they are now also applied to lower limb, to stroke and to some spinal cord injuries.

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“…9 All patients underwent a single surgery in which all nerve transfers were performed with end-to-end coaptation. Detailed description of the clinical cases can be found in Appendix A (available on the Journal's Web site at www.jhandsurg.org).…”

Section: Additional Proceduresmentioning

confidence: 99%

Transfer of the Radial Nerve Branch to the Extensor Carpi Radialis Brevis to the Anterior Interosseous Nerve to Reconstruct Thumb and Finger Flexion

Bertelli

2015

The Journal of Hand Surgery

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Distal Sensory Nerve Transfers in Lower-Type Injuries of the Brachial Plexus

Cited by 33 publications

References 24 publications

The intercostobrachial nerve as a sensory donor for hand reinnervation in brachial plexus reconstruction is a feasible technique and may be useful for restoring sensation

The intercostobrachial nerve as a sensory donor for hand reinnervation in brachial plexus reconstruction is a feasible technique and may be useful for restoring sensation

Nerve Transfers in the Treatment of Peripheral Nerve Injuries

Transfer of the Radial Nerve Branch to the Extensor Carpi Radialis Brevis to the Anterior Interosseous Nerve to Reconstruct Thumb and Finger Flexion

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