前骨间神经远端神经化恢复手部抓握。

IF 0.5 4区 医学 Q4 ORTHOPEDICS
Álvaro Baik Cho, Carlos Henrique Vieira Ferreira, Renan Martins Fontana, Gary Alan Ângulo Montano, Leandro Yoshinobu Kiyohara, Luiz Sorrenti
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引用次数: 0

摘要

下躯干病变并不常见,约占成人臂丛病变的3 - 5%。这种类型的损伤患者失去的功能之一是手指的屈曲,手掌握力受到重要伤害。这一系列的病例建议将桡神经分支转移到前骨间神经(AIN),为治疗这些病变提供了一种新的选择,结果非常令人满意。目的:介绍我们在臂丛下干离体病变中进行AIN再神经植入术的策略、技术和结果。方法:前瞻性队列研究,4例患者接受神经化治疗。治疗的目的是恢复手指的手部屈肌和握力。结果:所有患者均有拇长屈肌(FPL)和2、3、4指深屈肌神经再生。5指深屈肌也显示神经再支配,但强度(M3/4)较其他(M4+)减弱。结论:尽管本研究和其他研究的病例数量有限,但结果一致良好,可以认为这种治疗是可预测的。证据等级IV,案例系列。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

DISTAL NEUROTIZATION OF THE ANTERIOR INTEROSSEOUS NERVE TO RECOVER HAND GRASPING.

DISTAL NEUROTIZATION OF THE ANTERIOR INTEROSSEOUS NERVE TO RECOVER HAND GRASPING.

DISTAL NEUROTIZATION OF THE ANTERIOR INTEROSSEOUS NERVE TO RECOVER HAND GRASPING.

Lower trunk lesions are uncommon, representing about 3 to 5% of brachial plexus lesions in adults. One of the functions lost by patients who suffer this type of injury is the flexion of the fingers, with important harming of palmar grip. This series of cases proposes the transfer of a branch of the radial nerve to the anterior interosseous nerve (AIN), presenting a new alternative for the treatment of these lesions with highly satisfactory results.

Objective: To demonstrate our strategy, technique, and results in the reinnervation of the AIN in lesions isolated from the lower trunk of the brachial plexus in four cases of high lesion of the median nerve.

Method: Prospective cohort study in which four patients underwent neurotizations. The treatment was directed to the recovery of the fingers' flexors of the hand and the grip.

Results: All patients presented reinnervation of the flexor pollicis longus (FPL) and deep flexors of the 2nd, 3rd, and 4th fingers. The deep flexor of the 5th finger also showed reinnervation but with reduced strength (M3/4) comparing to the others (M4+).

Conclusion: Despite the limited number of cases in this and other studies, the results are uniformly good, allowing to consider this treatment predictable. Level of Evidence IV, Case Series.

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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
67
审稿时长
25 weeks
期刊介绍: A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.
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