Early nerve protection with anterior interosseous nerve in modified end-to-side neurorrhaphy repairs high ulnar nerve injury: a hypothesis of a novel surgical technique

Li, Qingtian; Zhang, Peixun; Yin, Xiaofeng; Jiang, Baoguo

doi:10.3109/21691401.2013.848873

Cited by 14 publications

(17 citation statements)

References 20 publications

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“…The normal structure and function of motor endplates depend on the integrity of nerve fibres and determine the function of skeletal muscles. More importantly, they are considered as the key factors affecting the post-traumatic recovery of neurological function [5,6]. The skeletal muscle function can be evaluated by CMAPs and tetanic contractions.…”

Section: Discussionmentioning

confidence: 99%

“…As the amplitude size and shape of CMAP depend on the location of recording electrodes [21][22][23][24], the nerve fibre types [18] and the features and number of motor endplate in skeletal muscle [5,25], the measurement of CMAP is not the most direct method in the evaluation of muscle function. However, muscle strength, which is not affected by the electrode Figure 7.…”

Section: Discussionmentioning

confidence: 99%

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How many nerve fibres can be separated as donor from an integral nerve trunk when reconstructing a peripheral nerve trauma with amplification method by artificial biochitin conduit?

Yin

Zhang

Kou

et al. 2018

Artificial Cells, Nanomedicine, and Biotechnology

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Using portion of a nearby nerve trunk to reconstruct a severe nerve lesion by artificial biodegradable chitin conduit is the core practicable method based on peripheral nerve amplification regeneration. However, the quantitative influences on skeletal muscle function corresponding to the injury of the donated nerve fibres were not previously reported. Here, we aimed to explore the compensative capacity in tibialis anterior muscles of rats with the models of acute tibialis anterior nerve branch injuries. The tibialis anterior branch of deep peroneal nerve was transected in various levels each time. Both the decreased treads of maximal compound muscle action potential (CMAP) amplitude and complete tetanic tension of the tibialis anterior muscle in rats were similar with the increasing numbers of damaged nerve fibres, which showed two S-shaped curves. When the nerve injury level was less than approximately 10%, the skeletal muscle function remained normal through complete compensation of motor endplates. As the injury degree went from 10% to 85%, the muscle function was partially impaired due to the broken compensation of motor endplates. When the nerve injury level was over approximately 85%, the skeletal muscle function was totally lost. It suggests that within a certain level of nerve injury, the skeletal muscle function maintained basically unchanged via complete compensation of motor endplates. Such nerve fibres may be used as donor nerve to repair peripheral nerve injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How many nerve fibres can be separated as donor from an integral nerve trunk when reconstructing a peripheral nerve trauma with amplification method by artificial biochitin conduit?

Yin

Zhang

Kou

et al. 2018

Artificial Cells, Nanomedicine, and Biotechnology

Self Cite

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show abstract

“…It has been proposed that axons may grow through an epineural window in a damaged recipient nerve by means, for instance, of a reversed end-to-side neurorraphy. [14,15] Other studies have demonstrated that operative injury to the donor nerve during ESN is the main prerequisite for motor reinnervation of the recipient nerve.…”

Section: Discussionmentioning

confidence: 99%

Early muscle reinnervation by means of end-to-side neurorrhaphy in an experimental model

Pérez¹,

Reynoso²,

Romero³

et al. 2017

PAR

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“…Additionally, though motor function of the hand is more important than sensory function for quality of life, motor recovery is less reliable due to progressive motor endplate loss and muscular atrophy, 6 even despite early and well-performed microsurgical nerve repair. 6,7 Current ulnar nerve repair strategies include primary microsurgical repair, conduit-assisted repair, or reconstruction with an autograft or allograft. If the injury occurs around the level of the elbow, then transposition should be considered to minimize tension on the repair.…”

Section: Introductionmentioning

confidence: 99%

Anterior Interosseous Nerve to Ulnar Nerve Transfers: A Systematic Review

Luikart

Kistler

Kahan

et al. 2023

Journal of Hand and Microsurgery

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Background There has been an increasing utilization of end-to-end (ETE) and reverse “supercharged” end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfers (NTs) for treatment of high ulnar nerve injury. This study aimed to review the potential indications for, and outcomes of, ETE and SETS AIN–ulnar NT. Methods A literature review was performed, and 10 articles with 156 patients who had sufficient follow-up to evaluate functional outcomes were included. English studies were included if they reported the outcome of patients with ulnar nerve injuries treated with AIN to ulnar motor NT. Outcomes were analyzed based on the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire scores, grip and key pinch strength, and interosseous Medical Research Council–graded motor strength. Comparisons were made using the independent t-test and the chi-square test. No nerve graft control group was required for eligibility. Ulnar nerve injury types varied. Results NT resulted in 77% of patients achieving M3+ recovery, 53.7 ± 19.8 lb grip strength recovery, 61 ± 21% key pinch recovery, and a mean DASH score of 33.4 ± 16. In this diverse group, NT resulted in significantly greater M3+ recovery and grip strength recovery measured in pounds than in the nerve graft/conventional treatment group, and ETE repairs had significantly better outcomes compared with SETS repairs for grip strength, key pinch strength, and DASH scores, but heterogeneity limits interpretation. Conclusion ETE and SETS AIN–ulnar NTs produce significant restoration of ulnar nerve motor function for high ulnar nerve injuries. For ulnar nerve transection injuries at or above the elbow, ETE NT results in superior motor recovery compared with nerve grafting/conventional repair. However, further research is needed to determine the best treatment for other types of ulnar nerve injury and the role of SETS NT.

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Early nerve protection with anterior interosseous nerve in modified end-to-side neurorrhaphy repairs high ulnar nerve injury: a hypothesis of a novel surgical technique

Cited by 14 publications

References 20 publications

How many nerve fibres can be separated as donor from an integral nerve trunk when reconstructing a peripheral nerve trauma with amplification method by artificial biochitin conduit?

How many nerve fibres can be separated as donor from an integral nerve trunk when reconstructing a peripheral nerve trauma with amplification method by artificial biochitin conduit?

Early muscle reinnervation by means of end-to-side neurorrhaphy in an experimental model

Anterior Interosseous Nerve to Ulnar Nerve Transfers: A Systematic Review

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