Mackinnon Susan E, Colbert Stephen H
Division of Plastic and Reconstructive Surgery Department of Surgery Washington University School of Medicine St. Louis, MO, USA.
Tech Hand Up Extrem Surg. 2008 Mar;12(1):20-33. doi: 10.1097/BTH.0b013e31812714f3.
Modern nerve-to-nerve transfers represent one of the greatest advances in peripheral nerve surgery. Lessons of tendon transfers have taught that nerves to specific musculotendinous units are expendable, and greater understanding of peripheral nerve topography has revealed redundant fascicles in peripheral nerves. Transfer of these redundant or expendable nerves to recipient nerves close to the end organ allows for earlier reinnervation and preservation of those musculotendinous units. Such nerve transfers provide significantly better treatment options in many cases of nerve injury where previous outcomes were expected to be poor, such as with proximal injuries, long nerve gaps, or unavailability of the proximal injured segment. This article will review current nerve transfers in the hand and upper extremity.
现代神经对神经移位术是周围神经外科领域最重大的进展之一。肌腱移位术的经验表明，支配特定肌肉肌腱单位的神经是可以牺牲的，而对周围神经局部解剖的更深入了解揭示了周围神经中存在多余的束支。将这些多余或可牺牲的神经移位至靠近终末器官的受区神经，可实现更早的神经再支配，并保留那些肌肉肌腱单位。在许多以往预期预后不佳的神经损伤病例中，如近端损伤、长神经缺损或近端损伤节段无法利用时，这种神经移位术提供了显著更好的治疗选择。本文将综述目前手部及上肢的神经移位术。
