Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, P. R. China.
NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai, P. R. China.
J Hand Surg Eur Vol. 2023 Sep;48(8):731-737. doi: 10.1177/17531934231170103. Epub 2023 May 19.
Contralateral C7 (cC7) transfer is a technique used in patients with total brachial plexus avulsion. An ulnar nerve graft (UNG) is usually used, as intrinsic function is not expected to be restored due to length of reinnervation required. In this study, we attempted to improve intrinsic function recovery by preserving the deep branch of the ulnar nerve (dbUN) and reanimating it with the anterior interosseous nerve (AIN) after cC7 transfer. Fifty-four rats were divided into the following three groups: Group A, traditional cC7 transfer to the median nerve with a UNG; Group B, cC7 transfer preserving and repairing the dbUN with the terminal branch of the AIN; Group C, same as Group B; however, the dbUN was coapted after 1 month with the AIN. At 3, 6 and 9 months postoperatively, the results of electrodiagnostic and histomorphometric examinations of the interosseous muscle were significantly better in Groups B and C, without affecting AIN recovery. In conclusion, the modified cC7 transfer technique can potentially improve intrinsic function recovery without affecting median nerve recovery.
健侧 C7（cC7）神经移位术是治疗全臂丛根性撕脱伤的常用方法。由于需要较长的神经再支配，预计内在功能无法恢复，因此通常使用尺神经移植（UNG）。在这项研究中，我们试图通过保留尺神经深支（dbUN）并在 cC7 转移后用骨间前神经（AIN）对其进行再支配来改善内在功能的恢复。54 只大鼠分为以下三组：A 组，传统的 cC7 转移到正中神经并使用 UNG；B 组，cC7 转移时保留和修复 dbUN 并与 AIN 的终末支吻合；C 组，与 B 组相同；然而，dbUN 在术后 1 个月与 AIN 吻合。术后 3、6 和 9 个月，对骨间肌的电诊断和组织形态计量学检查结果显示，B 组和 C 组的内在功能恢复明显更好，而不会影响 AIN 的恢复。总之，改良的 cC7 转移技术可能在不影响正中神经恢复的情况下，提高内在功能的恢复。
