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周围神经损伤的神经远侧转移术:适应证和结果。

Distal nerve transfers for peripheral nerve injuries: indications and outcomes.

机构信息

Department of Surgery, Federal University of Santa Catarina, Florianópolis, Brazil.

Department of Orthopedics and Traumatology, Governador Celso Ramos Hospital, Florianópolis, Santa Catarina, Brazil.

出版信息

J Hand Surg Eur Vol. 2024 Jun;49(6):721-733. doi: 10.1177/17531934231226169. Epub 2024 Jan 31.

Abstract

Distal nerve transfer is a refined surgical technique involving the redirection of healthy sacrificable nerves from one part of the body to reinstate function in another area afflicted by paralysis or injury. This approach is particularly valuable when the original nerves are extensively damaged and standard repair methods, such as direct suturing or grafting, may be insufficient. As the nerve coaptation is close to the recipient muscles or skin, distal nerve transfers reduce the time to reinnervation. The harvesting of nerves for transfer should usually result in minimal or no donor morbidity, as any anticipated loss of function is compensated for by adjacent muscles or overlapping cutaneous territory. Recent years have witnessed notable progress in nerve transfer procedures, markedly enhancing the outcomes of upper limb reconstruction for conditions encompassing peripheral nerve, brachial plexus and spinal cord injuries.

摘要

神经远侧移位术是一种精细的外科技术,涉及将健康的可牺牲神经从身体的一部分重新引导到另一个受瘫痪或损伤影响的区域,以恢复功能。当原始神经广泛受损,而标准修复方法(如直接缝合或移植)可能不足时,这种方法特别有价值。由于神经吻合接近受者肌肉或皮肤,因此神经远侧移位术可缩短神经再支配的时间。用于转移的神经采集通常应导致最小或没有供体发病率,因为任何预期的功能丧失都可通过相邻肌肉或重叠的皮肤区域得到补偿。近年来,神经转移手术取得了显著进展,显著提高了上肢重建的效果,涵盖了周围神经、臂丛和脊髓损伤等疾病。

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