Chopan Mustafa, Spencer Nichols David, Chim Harvey
Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, Fla.
Plast Reconstr Surg Glob Open. 2022 Aug 15;10(8):e4483. doi: 10.1097/GOX.0000000000004483. eCollection 2022 Aug.
New developments in targeted muscle reinnervation promise better options for treatment of neuropathic pain and improved prosthetic control. For transhumeral amputations, the traditional approach involves an anterior incision to access the median and ulnar nerves and a second posterior incision to access the radial nerve. This is necessitated as exposure of motor branches of the radial nerve distal to the branch to the long head of the triceps is difficult from the anterior approach. Herein, we describe a technique for transferring the radial nerve proper distal to the long head branch to a motor branch to the medial or lateral head of the triceps through internal neurolysis and fascicular transfer. This allows all surgical steps to be performed through a single incision while preserving native motor branches to the biceps and triceps muscles.
靶向肌肉再支配的新进展为治疗神经性疼痛和改善假肢控制带来了更好的选择。对于经肱骨截肢，传统方法包括一个前侧切口以显露正中神经和尺神经，以及第二个后侧切口以显露桡神经。之所以需要这样做，是因为从前侧入路很难暴露桡神经在肱三头肌长头分支远端的运动分支。在此，我们描述一种技术，即通过内部神经松解和束状转移，将肱三头肌长头分支远端的桡神经主干转移至肱三头肌内侧或外侧头的运动分支。这使得所有手术步骤都可以通过单一切口完成，同时保留肱二头肌和肱三头肌的天然运动分支。
