中国神经再生研究(英文版) ›› 2017, Vol. 12 ›› Issue (1): 143-148.doi: 10.4103/1673-5374.199007

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

骨间后神经的食指固有伸肌分支移植修复尺神经和正中神经高位损伤:解剖学研究

  

  • 收稿日期:2016-12-16 出版日期:2017-01-15 发布日期:2017-01-15
  • 基金资助:

    江苏省卫生厅面上项目(H201414),苏州市科技发展计划项目(SYS201468),苏州市科技计划项目(SS201636),苏州大学附属第二医院优势临床学科群项目(XKQ2015010),苏州大学附属第二医院科研预研基金项目(SDFEYQN1403)

Transfer of the extensor indicis proprius branch ofposterior interosseous nerve to reconstruct ulnar nerve and median nerve injured proximally: an anatomical study

Pei-ji Wang, Yong Zhang, Jia-ju Zhao, Ju-pu Zhou, Zhi-cheng Zuo, Bing-bing Wu   

  1. Department of Hand and Foot Surgery, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
  • Received:2016-12-16 Online:2017-01-15 Published:2017-01-15
  • Contact: Pei-ji Wang, M.D., wangpeiji88@163.com.
  • Supported by:

    This study was supported by the General Program of Health Department of Jiangsu Province in China, No. H201414; the Science and Technology Development and Planning Program of Suzhou City in China, No. SYS201468; the Science and Technology and Planning Program of Suzhou City in China, No.SS201636; the Second Affiliated Hospital of Soochow University Preponderant Clinic Discipline Group Project in China, No. XKQ2015010; the Science Pre-Research Project of the Second Affiliated Hospital of Soochow University in China, No. SDFEYQN1403.

摘要:

尺神经或正中神经近端及中部的病变,即便经过最细致的显微外科手术或神经移植治疗,也会造成手部运动功能的丧失。既往研究显示,神经移植在修复方面似乎效果更佳。我们对9具新鲜尸体进行解剖学研究,探索以含有运动神经纤维的骨间后神经移植修复支配食指固有伸肌的尺神经深支或正中神经鱼际肌支的可行性。结果显示,骨间后神经的食指固有伸肌分支、尺神经深支和正中神经鱼际肌支的神经干直径、纤维束数量及有髓神经纤维数量接近。说明使用骨间后神经的食指固有伸肌分支重建尺神经深支和正中神经鱼际肌支是可能和可行的。这可能为修复尺神经或正中神经损伤后手内在肌功能提供了一种新的方法。

ORCID:0000-0001-6131-2030(Pei-ji Wang)

Abstract:

 

Proximal or middle lesions of the ulnar or median nerves are responsible for extensive loss of hand motor function. This occurs even when the most meticulous microsurgical techniques or nerve grafts are used. Previous studies had proposed that nerve transfer was more effective than nerve grafting for nerve repair. Our hypothesis is that transfer of the posterior interosseous nerve, which contains mainly motor fibers, to the ulnar or median nerve can innervate the intrinsic muscles of hands. The present study sought to investigate the feasibility of reconstruction of the deep branch of the ulnar nerve and the thenar branch of median nerve by transferring the extensor indicis proprius branch of the posterior interosseous nerve obtained from adult cadavers. The results suggested that the extensor indicis proprius branch of the posterior interosseous nerve had approximately similar diameters and number of fascicles and myelinated nerve fibers to those of the deep branch of ulnar nerve and the thenar branch of the median nerve. These confirm the feasibility of extensor indicis proprius branch of posterior interosseous nerve transfer for reconstruction of the deep branch of the ulnar nerve and the thenar branch of median nerve. This procedure could be a novel and effective method for the functional recovery of the intrinsic muscles of hands after ulnar nerve or median nerve injury.

Key words: nerve regeneration;, posterior interosseous nerve, ulnar nerve, median nerve, extensor indicis proprius, thenar branch, nerve transfer, neural regeneration