ABSTRACT
Objective To explore the feasibility and effectiveness of lateral gastrocnemius muscle branch nerve transferring for deep pe-roneal nerve injury. Methods Thirty-two adult female Sprague-Dawley rats were divided into control group (n=8), sham group (n=8), nerve direct repairing group (n=8) and nerve transferring group (n=8). Twelve weeks after the anastomosis, the nerve anastomosis was observed vi-sually, the length of lateral of gastrocnemius muscle branch (L1), the diameter at the point of entering muscle (D1), the maximum detachable length of nervus peroneus communis (L2), the diameter of deep peroneal nerve (D2) and the distance between branch point and neck of fibu-la (S) were measured. The peroneal nerve functional index (PFI), the amplitude of compound muscle action potential (CMAP), nerve con-duction velocity (NCV), the weight of the tibialis anterior and the creatine kinase (CK) activity of theanterior tibial were compared among groups. Results L10.05). Conclusion It is feasible that lateral head muscular branches of gastrocnemius nerve transferring can repair deep peroneal nerve injury, which is needed to separate superficial peroneal nerve and deep peroneal nerve in the epineurium without damaging nerve for tension free neuroanastomosis. Lateral head muscular branches of gastrocnemius nerve transferring can repair the func-tion after deep peroneal nerve injury.
ABSTRACT
Objective To provide a good anatomical foundation for transposition of the branch of median nerve superficial flexor muscle repairing the movement branch of ulnar nerve to recover the function of intrinsic muscle, by anatomic study of the muscle branch of the superficial flexor muscle of the median nerve and the movement branch of ulnar nerve. Methods Twenty adult upper limb specimens immersed fixed by formalin were elected and expose the midian nerve and ulnar nerve. Then every anatomical index was measured. Simulate to manipulate that the branch of superficial flexor muscle repair the motor b ranch of ulnar nerve. Calculate the number of myelinated nerve fibers of the branch of superficial flexor muscle. Results The distance between the position into muscle and styloid process of radius and styloid process of ulna: (21.4±1.8)mm, the distance that can be separated: (27.1±1.2)mm, the transverse diameter: (1.2±0.2)mm, anteroposterior diameter: (0.7 ± 0.1 )mm. No injury separated distance between the sensory branch and motor branch of ulnar nerve: (7.1 ± 0.7)cm. The 4th muscular branches of median nerve flexor digitorum superficialis was 1378.9± 107.9. Conclusion The 4th muscular branches of median nerve flexor digitorum superficialis can be used to repair the motor branch of the ulnar nerve to recover the function of intrinsic muscle of hand.
ABSTRACT
La anatomía detallada de las estructuras de la mano es de importancia para efectuar diagnósticos precisos como también para restaurar las funciones después de lesiones en esta parte del miembro superior. Basados en esta premisa y con el propósito de aportar datos a este tema, sistematizamos la distribución del ramo profundo del nervio ulnar (RPNU) en relación a la inervación entregada a los músculos interóseos palmares y dorsales (IP e ID), lumbricales 3º y 4º (L3 y L4) y cabezas oblicua (COAP) y transversa (CTAP) del aductor del pulgar. Para ello, utilizamos 10 manos de cadáveres formolizados de individuos adultos, de sexo masculino, utilizando disección convencional. La disección e identificación de los ramos se hizo de medial hacia lateral. El primer ramo encontrado fue dirigido al m. L4 y al IP3, disposición observada en 9 casos. El m. L3 recibió un ramo que en su trayecto emitió uno para el m.IP2, lo que se observó en 7 casos. Los músculos ID4, ID3 e ID2 recibieron ramos únicos en 8, 7 y 7 casos respectivamente. El o los ramos para el m. ID1 se originaron de la división terminal del RPNU, recibiendo un único ramo en 3 casos y dos en los restantes. Para la COAP se observó que en 7 casos recibió solo un ramo y en los tres restantes 2, 3 y 4 ramos. La CTAP fue inervada en 9 casos por un solo ramo. El diámetro externo del RPNU antes de entregar los ramos descritos fue de 2,5 mm, después de emitir el ramo ID3 fue de 1,5 mm y su ramo terminal de 0,95 mm. Estos resultados son un aporte al conocimiento de la inervación de la mano y por ende, a la anatomía quirúrgica de ella.
The knowledge of hand anatomy is very important for give an exact diagnostic as too in the recovery of the functions after damages in this part of the upper limb. With the purpose to obtain details about this thema, we studied the distribution of the deep branch of the ulnar nerve (DBUN) in the palmar and dorsal interossei (PIm, DIm), lumbricals (Lm) and adductor pollicis (APm) muscles.Ten dissections of formolized cadaveric hands were performed under loupe magnification, all adults, of male sex. The nerves observation was made of medial towards lateral. The first branch observed was for Lm4 and PIm3, disposition found in 9 cases. The Lm3 received a branch that too innervated to the PIm2, in 7 cases. TheDIm4, DIm3 and DIm2 muscles received only one branch in 8, 7 and 7 cases, respectively The branch or branches for the DIml originated from the terminal division of DBUN, receiving only one branch in 3 cases and two in the rest of the cases. The oblique head of the APm received only one branch in 7 cases and two, three and four branches in 3 cases; the transverse head of theAPm received one branch in 9 cases. The external diameter of DBUN before to give the described branches was 2.5 mm; after the DIm3 origin was 1.5 mm and its terminal branch was 0.95 mm. These results are a complement to the knowledge of the hand innervation and the surgical procedures in this region.