[Peripheral nerve grafting].

IF 1 4区医学 Q3 ORTHOPEDICS

Operative Orthopadie Und Traumatologie Pub Date : 2024-10-07 DOI:10.1007/s00064-024-00862-w

Ali Ayache, Frank Unglaub, Adrian Cavalcanti Kußmaul, Christian K Spies, Martin F Langer

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引用次数: 0

Abstract

Objective: Peripheral nerve lesions often lead to significant and permanent loss of motor and sensory function. The aim of peripheral nerve grafting is to bridge nerve defects.

Indications: When tension-free nerve repair is not possible, peripheral nerve grafting is indicated.

Contraindications: Local infection, insufficient soft tissue coverage, significant muscle atrophy or joint contraction in case of "motor" nerve grafting, lack of microsurgical instruments or experience, life-threatening injuries.

Surgical technique: Exposure and preparation of the nerve stumps. Choosing and preparation of the donor nerve. Approximation. Nerve repair. Nerve reconstruction must always be tension-free as nerve repair with tension frequently leads to disruption of nerve healing and poor functional outcome. Autologous nerve grafting from various donor sites leads to excellent functional results with little sensory deficits at the donor regions.

Postoperative management: Limited immobilization, physiotherapy, ergotherapy, regular clinical and neurological assessments.

Results: Outcome of peripheral nerve grafting may, for example, depend on defect length, caliber and quality of the injured nerve, quality of the donor nerve, microsurgical expertise of the surgeon, time of reconstruction, and age of the patient.

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[周围神经移植术]。

目的：外周神经损伤通常会导致运动和感觉功能的显著和永久性丧失。周围神经移植的目的是弥合神经缺损：禁忌症：局部感染、软组织覆盖不足：禁忌症：局部感染、软组织覆盖不足、"运动 "神经移植时肌肉明显萎缩或关节收缩、缺乏显微外科器械或经验、危及生命的损伤：暴露和准备神经残端。选择和准备供体神经。逼近。神经修复。神经重建必须始终保持无张力，因为有张力的神经修复经常会导致神经愈合中断和功能不良。从不同供体部位进行自体神经移植可获得极佳的功能效果，供体区域几乎没有感觉障碍：术后管理：有限的固定、理疗、工效疗法、定期临床和神经评估：结果：外周神经移植手术的结果可能取决于缺损长度、损伤神经的口径和质量、供体神经的质量、外科医生的显微外科专业知识、重建时间和患者年龄等因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Operative Orthopadie Und Traumatologie ORTHOPEDICS-

CiteScore

2.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care. The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems. Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.