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采用跨越神经移植技术治疗连续性瘢痕束缚性正中神经神经瘤。

Treating a Scar-Tethered Median Nerve Neuroma in Continuity With a Fly-Over Nerve Grafting Technique.

作者信息

Karagergou Eleni, Pantelidis Emmanouil, Kitridis Dimitrios, Givissis Panagiotis

机构信息

1 Orthopaedic Department, Aristotle University of Thessaloniki, Papanikolaou Hospital, Thessaloniki, Greece.

Orthopedics and Trauma Department, 424 Army General Training Hospital, Thessaloniki, Greece.

出版信息

J Hand Surg Glob Online. 2024 Aug 28;6(6):924-926. doi: 10.1016/j.jhsg.2024.08.001. eCollection 2024 Nov.

DOI:10.1016/j.jhsg.2024.08.001
PMID:39703576
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11652276/
Abstract

Peripheral nerve neuromas may present significant therapeutic challenges especially when neuromas in continuity are scar-tethered to adjacent vital structures. We report a case of a patient who presented with delayed neurotmesis of median and ulnar nerves in the arm while extensive scarring of the median nerve was found in close proximity to the repaired brachial artery. For the surgical restoration of the continuity of the median nerve, the scarred segment was left in situ to avoid reinjury of the brachial artery and a "fly-over" nerve grafting technique with sural nerve autografts was employed.

摘要

周围神经神经瘤可能带来重大的治疗挑战，尤其是当连续性神经瘤因瘢痕而与相邻重要结构相连时。我们报告一例患者，其手臂正中神经和尺神经出现延迟性神经断裂，同时发现正中神经在靠近修复后的肱动脉处有广泛瘢痕形成。为了手术恢复正中神经的连续性，保留了瘢痕化节段以避免肱动脉再次受伤，并采用了腓肠神经自体移植的“跨越”神经移植技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cc/11652276/ad0223dbfb53/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cc/11652276/158b5598af72/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cc/11652276/ab6b7b2729ce/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cc/11652276/7c10fdb7e976/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cc/11652276/6f05245b412a/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cc/11652276/ad0223dbfb53/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cc/11652276/158b5598af72/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cc/11652276/ab6b7b2729ce/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cc/11652276/7c10fdb7e976/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cc/11652276/6f05245b412a/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34cc/11652276/ad0223dbfb53/gr5.jpg

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本文引用的文献

1
The Effect of Surgical Timing on Upper Extremity Nerve Repair.手术时机对上肢神经修复的影响。
Hand (N Y). 2025 Jan;20(1):92-97. doi: 10.1177/15589447231198125. Epub 2023 Sep 14.
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Histologic Comparison of the Fascicular Area of Processed Nerve Allograft Versus Cabled Sural Nerve Autograft.处理过的同种异体神经移植体与腓肠神经自体移植体束状区域的组织学比较。
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Surgically Treated Neuroma in Upper Extremity: Patient Characteristics and Factors Influencing Outcome of Surgery.
上肢手术治疗的神经瘤：患者特征及影响手术结果的因素
Plast Reconstr Surg Glob Open. 2022 Jan 31;10(1):e4076. doi: 10.1097/GOX.0000000000004076. eCollection 2022 Jan.
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Targeted Muscle Reinnervation for Symptomatic Neuromas Utilizing the Terminal Anterior Interosseous Nerve.利用骨间前终末神经对有症状的神经瘤进行靶向肌肉再支配
Plast Reconstr Surg Glob Open. 2020 Jul 14;8(7):e2979. doi: 10.1097/GOX.0000000000002979. eCollection 2020 Jul.
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Peripheral nerve repair throughout the body with processed nerve allografts: Results from a large multicenter study.使用处理过的同种异体神经移植物进行全身周围神经修复：一项大型多中心研究的结果。
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7
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A classification of peripheral nerve injuries producing loss of function.导致功能丧失的周围神经损伤分类。
Brain. 1951 Dec;74(4):491-516. doi: 10.1093/brain/74.4.491.
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A technique for the treatment of neuroma in-continuity.一种治疗连续性神经瘤的技术。
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