Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.
Department of Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany.
Eur J Orthop Surg Traumatol. 2024 Oct;34(7):3687-3697. doi: 10.1007/s00590-023-03751-3. Epub 2023 Oct 21.
Peripheral nerve lesions of the upper extremity are common and are associated with devastating limitations for the patient. Rapid and accurate diagnosis of the lesion by electroneurography, neurosonography, or even MR neurography is important for treatment planning. There are different therapeutic approaches, which may show individual differences depending on the injured nerve. If a primary nerve repair is not possible, several strategies exist to bridge the gap. These may include autologous nerve grafts, bioartificial nerve conduits, or acellular nerve allografts. Tendon and nerve transfers are also of major importance in the treatment of nerve lesions in particular with long regeneration distances. As a secondary reconstruction, in addition to tendon transfers, there is also the option for free functional muscle transfer. In amputations, the prevention of neuroma is of great importance, for which different strategies exist, such as target muscle reinnervation, regenerative peripheral nerve interface, or neurotized flaps. In this article, we give an overview of the latest methods for the therapy of peripheral nerve lesions.
上肢周围神经损伤很常见，会给患者带来严重的功能障碍。通过电神经图、神经超声或甚至磁共振神经成像快速准确地诊断病变对于治疗计划非常重要。有不同的治疗方法，根据损伤的神经，可能会显示出个体差异。如果不能进行主要的神经修复，有几种策略可以用来桥接间隙。这些方法可能包括自体神经移植物、生物人工神经导管或去细胞同种异体神经移植物。肌腱和神经转移在治疗神经损伤，特别是长距离再生时也非常重要。作为二次重建，除了肌腱转移，还有游离功能性肌肉转移的选择。在截肢中，预防神经瘤非常重要，为此存在不同的策略，例如靶肌肉再神经支配、再生周围神经界面或神经化皮瓣。本文概述了周围神经损伤治疗的最新方法。
