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Schenck, T.L.* ; Lin, S.* ; Stewart, J.K.* ; Koban, K.C.* ; Aichler, M. ; Rezaeian, F.* ; Giunta, R.E.*

Sensory reanimation of the hand by transfer of the superficial branch of the radial nerve to the median and ulnar nerve.

Brain Behav. 6:e00578 (2016)

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Background: It remains a surgical challenge to treat high-grade nerve injuries of the upper extremity. Extra-anatomic reconstructions through the transfer of peripheral nerves have gained clinical importance over the past decades. This contribution outlines the anatomic and histomorphometric basis for the transfer of the superficial branch of the radial nerve (SBRN) to the median nerve (MN) and the superficial branch of the ulnar nerve (SBUN). Methods: The SBRN, MN, and SBUN were identified in 15 specimens and the nerve transfer performed. A favorable site for coaptation was chosen and its location described using relevant anatomical landmarks. Histomorphometric characteristics of donor and target were compared to evaluate the chances of a clinical success. Results: A suitable location for dissecting the SBRN was identified prior to its first bifurcation. Coaptations were possible near the pronator quadratus muscle, approximately 22 cm distal to the lateral epicondyle of the humerus. The MN and SBUN had to be dissected interfasciculary over 82 ± 5.7 mm and 49 ± 5.5 mm, respectively. Histomorphometric analysis revealed sufficient donor-to-recipient axon ratios for both transfers and identified the SBRN as a suitable donor with high axon density. Conclusion: Our anatomic and histomorphometric results indicate that the SBRN is a suitable donor for the MN and SBUN at wrist level. The measurements show feasibility of this procedure and shall help in planning this sensory nerve transfer. High axon density in the SBRN identifies it or its branches an ideal candidate for sensory reanimation of fingers and thumbs.

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Publication type Article: Journal article

Document type Scientific Article

Corresponding Author

Keywords Hand Trauma ; Histomorphometric Nerve Analysis ; Nerve Injury ; Nerve Reconstruction ; Peripheral Nerve Transfer ; Reinnervation; Anterior Interosseous Nerve; Brachial-plexus; Functional Recovery; Facial Reanimation; Injuries; Lesions; Repair; Motor; Denervation; Sensibility

ISSN (print) / ISBN 2162-3279

Journal Brain and behavior

Quellenangaben Volume: 6, Issue: 12, Article Number: e00578

Publisher Wiley

Publishing Place Malden, Mass.

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Research Unit Analytical Pathology (AAP)