From the Division of Plastic and Reconstructive Surgery, Washington University School of Medicine; and the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center.
Plast Reconstr Surg. 2021 May 1;147(5):830e-845e. doi: 10.1097/PRS.0000000000007865.
After studying this article and accompanying videos, the participant should be able to: 1. Understand and apply the principles of nerve transfer surgery for nerve injuries. 2. Discuss important considerations when performing nerve transfers, such as aspects of surgical technique and perioperative decision-making. 3. Understand indications for end-to-end versus supercharged reverse end-to-side nerve transfers. 4. Understand an algorithm for treating nerve injuries to include the indications and surgical techniques of five nerve transfers commonly performed for the treatment of isolated upper extremity nerve injuries. 5. Understand the outcomes and postoperative management of the discussed nerve transfers.
Nerve transfers are gaining wide acceptance because of their superior results in the management of many nerve injuries of the upper extremity. This article presents five nerve transfers for the treatment of isolated nerve injuries in the authors' upper extremity nerve practice that offer reliable results. Indications, surgical techniques, outcomes, and postoperative management are reviewed. To maximize functional outcomes in patients with nerve injuries, the treatment should be individualized to the patient, and the principles for nerve transfers as described herein should be considered.
学习本文及相关视频后,学员应能够:1. 理解并应用神经转移手术治疗神经损伤的原则。2. 讨论进行神经转移时的重要注意事项,如手术技术和围手术期决策的各个方面。3. 了解端端吻合与增强型逆行端侧吻合的适应证。4. 了解治疗神经损伤的算法,包括为治疗孤立上肢神经损伤而常进行的 5 种神经转移的适应证和手术技术。5. 了解所讨论的神经转移的结果和术后管理。
由于神经转移在治疗上肢多种神经损伤方面具有优越的效果,因此其越来越受到广泛认可。本文介绍了作者上肢神经实践中用于治疗孤立性神经损伤的 5 种神经转移术,这些神经转移术可提供可靠的效果。本文回顾了适应证、手术技术、结果和术后管理。为了使神经损伤患者获得最大的功能结果,应根据患者的具体情况对治疗进行个体化,并且应考虑本文所述的神经转移原则。