端侧 AIN 至尺侧运动神经转移后的早期和晚期手部内在肌肉再神经支配

IF 1.8 Q2 ORTHOPEDICS
HAND Pub Date : 2024-11-06 DOI:10.1177/15589447241286263
Eric C Mitchell, Mehran Mansouri, Thomas Miller, Douglas Ross, Joshua Gillis
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引用次数: 0

摘要

背景:在严重尺神经压迫或近端轴突损伤的病例中,"增压 "端对侧(SETS)前内侧神经(AIN)至尺运动神经转移被用于改善内在肌肉恢复。之前的研究发现,这种转移后内在肌肉的恢复情况各不相同。本研究的目的是研究第一背侧肌间肌(FDI)和小伸肌(ADM)的恢复模式,以及将 AIN 转移到特定筋膜位置对尺神经运动神经的影响:方法:对一位接受过研究员培训的外科医生在2019年12月至2021年9月期间在一个中心的连续患者进行了回顾性审查。结果:纳入了 17 例患者(88%),其中有 1 例患者接受了 AIN 至尺运动神经转移术:共纳入 17 名患者(88% 为男性,平均年龄为 55 ± 14 岁)。在早期随访中,ADM 和 FDI 的复合肌肉动作电位振幅没有增加。在后期随访中,ADM 的复合肌肉动作电位振幅明显增加(P P P P P 结论:SETS AIN 至尺肌的复合肌肉动作电位振幅明显增加:SETS AIN 到尺骨运动神经转移显示了内在肌肉恢复和神经再支配的临床和电生理学证据,其恢复结果各不相同。特定筋束靶向的作用仍不明确,需要进一步研究,不同内在恢复背后的机制也是如此。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early and Late Intrinsic Hand Muscle Reinnervation After End-to-Side AIN to Ulnar Motor Nerve Transfer.

Background: The "supercharge" end-to-side (SETS) anterior-interosseous-nerve (AIN) to ulnar-motor nerve transfer is used to improve intrinsic muscle recovery in cases of severe ulnar nerve compression or proximal axonotmetic injuries. Previous work has found differing intrinsic muscle recovery after this transfer. The objectives of this study were to examine the patterns of recovery in first dorsal interossei (FDI) and abductor digiti minimi (ADM) and the impact of AIN transfer to a specific fascicular location on the ulnar-motor nerve.

Methods: A retrospective review of one fellowship-trained surgeon's consecutive patients at a single center from December 2019 to September 2021 was conducted. Patients who had an AIN to ulnar-motor nerve transfer for any indication were included and were excluded if they had less than 9 months follow-up.

Results: Seventeen patients were included (88% male, mean age 55 ± 14 years). At early follow-up, compound muscle action potential amplitudes for ADM and FDI did not increase. Compound muscle action potential amplitude for ADM significantly increased at late follow-up (P < .01). Average British Medical Research Council (BMRC) strength increased at early follow-up for FDI (P < .05), but not ADM. The proportion of patients with BMRC ≥ 3 increased for FDI (P < .01) and ADM (P < .05) at late follow-up. Volar-ulnar AIN insertion position did not have a clear effect on outcomes.

Conclusions: The SETS AIN to ulnar-motor nerve transfer demonstrates clinical and electrophysiologic evidence of intrinsic muscle recovery and reinnervation, with differing recovery of outcomes. The role of specific fascicular targeting is still unclear and required further examination as does the mechanism behind differing intrinsic recovering.

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来源期刊
HAND
HAND Medicine-Surgery
CiteScore
3.30
自引率
0.00%
发文量
209
期刊介绍: HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.
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