Heinzel Johannes, Prahm Cosima, Lauer Henrik, Daigeler Adrien, Hurth Helene, Schuhmann Martin, Kolbenschlag Jonas
Klinik für Hand‑, Plastische, Rekonstruktive und Verbrennungschirurgie, BG Unfallklinik Tübingen, Eberhard Karls Universität Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Deutschland.
Klinik für Neurochirurgie am Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen, Tübingen, Deutschland, Hoppe-Seyler-Straße 3, 72076.
Nervenarzt. 2023 Dec;94(12):1097-1105. doi: 10.1007/s00115-023-01543-y. Epub 2023 Sep 18.
The functional deficits that develop after a peripheral nerve injury mean a considerable reduction in the quality of life for the affected patients. However, interventions on the injured nerve are not always possible or effective. In this case, secondary procedures, e.g. tendon transfers, are a feasible option for functional reconstruction.
An overview of the most common secondary surgical procedures for functional reconstruction after peripheral nerve injuries.
Presentation and discussion of the most common secondary surgical procedures with emphasis on tendon transfers. Illustration of the primary functions that need to be reconstructed depending on the respective nerve lesion.
The basic principle of secondary surgical procedures after nerve injuries is the transposition of a healthy tendomuscular unit to replace a lost function following a loss of muscle or tendon or if an intervention on the nerve is not promising. For example, by transferring flexor forearm muscles, wrist, finger and thumb extension can be reconstructed after radial nerve injury. By transposing the tibialis posterior muscle, dorsiflexion in the talocrural joint can be restored to enable the affected patient to walk safely without an orthosis.
Secondary surgical procedures are a valuable option for functional reconstruction after nerve injury.
周围神经损伤后出现的功能缺陷意味着受影响患者的生活质量大幅下降。然而，对受损神经进行干预并非总是可行或有效的。在这种情况下，二次手术，如肌腱转移，是功能重建的一种可行选择。
概述周围神经损伤后功能重建最常见的二次外科手术。
介绍和讨论最常见的二次外科手术，重点是肌腱转移。说明根据各自神经损伤需要重建的主要功能。
神经损伤后二次外科手术的基本原则是将健康的肌腱肌肉单元移位，以在肌肉或肌腱丧失功能后或对神经的干预没有希望时替代丧失的功能。例如，通过转移前臂屈肌，可以在桡神经损伤后重建手腕、手指和拇指的伸展功能。通过移位胫后肌，可以恢复踝关节背屈，使受影响的患者无需矫形器就能安全行走。
二次外科手术是神经损伤后功能重建的一个有价值的选择。
