Schaeffer Christine V, Menon Ambika, Chambers Spencer, Graf Alexander, Suh Nina, Ghareeb Paul
Department of Plastic and Reconstructive Surgery, University of Kentucky, Lexington, Kentucky, USA.
Department of Orthopedic Surgery and Plastic Surgery, Emory University, Atlanta, Georgia, USA.
Microsurgery. 2025 Jan;45(1):e70017. doi: 10.1002/micr.70017.
Loss of key-pinch sensation after median nerve injury poses significant functional detriment. Nerve transfers are utilized to improve function after nerve injury and size matching of donor and recipient nerves is important to optimize success. This anthropometric study investigates the anatomy of the superficial branch of the radial nerve (SBRN) to the thumb and index finger and explores radial to median sensory nerve transfers, a necessary but not heavily discussed facet of nerve transfers for the hand.
Anatomic dissection of SBRN in 15 cadaver hands was performed to assess variability in diameter and branching patterns based on nerve location. Dissection of the index radial and thumb ulnar digital nerves was performed to assess diameter based on location and calculate ideal size match for nerve transfer.
All specimen thumbs had 2 SBRN branches at the level of the metacarpal shaft and proximal phalanx; 87% had 2 index SBRN branches extending to the proximal phalanx. Index radial and ulnar SBRN branches were similar in diameter at all levels (p > 0.0167). There was a significant size mismatch between the individual SBRN branches and index digital at all measured levels (p < 0.0167). The thumb radial SBRN was significantly larger than ulnar SBRN (p = 0.006).
Optimal size match for transfer involved transection of radial index SBRN 1 cm distal to the MCP joint and ulnar thumb SBRN 1 cm distal to the MCP joint. Consideration should be made for transfer of both index SBRN branches at the level of the MCP joint to improve size match. Corresponding digital nerves were transected 1 cm proximal to the level of SBRN harvest.
正中神经损伤后关键捏力觉丧失会造成严重的功能损害。神经移位术用于改善神经损伤后的功能，供体神经与受体神经的大小匹配对于优化手术成功率很重要。这项人体测量学研究调查了桡神经浅支（SBRN）至拇指和示指的解剖结构，并探讨了桡神经至正中神经的感觉神经移位术，这是手部神经移位术中一个必要但未得到充分讨论的方面。
对15具尸体手进行SBRN解剖，以评估基于神经位置的直径和分支模式的变异性。对示指桡侧和拇指尺侧指神经进行解剖，以评估基于位置的直径，并计算神经移位的理想大小匹配。
所有标本的拇指在掌骨干和近节指骨水平均有2支SBRN分支；87%有2支示指SBRN分支延伸至近节指骨。示指桡侧和尺侧SBRN分支在所有水平的直径相似（p > 0.0167）。在所有测量水平，各SBRN分支与示指指神经之间均存在显著的大小不匹配（p < 0.0167）。拇指桡侧SBRN明显大于尺侧SBRN（p = 0.006）。
理想的移位大小匹配是在掌指关节（MCP）远侧1 cm处切断示指桡侧SBRN和在MCP关节远侧1 cm处切断拇指尺侧SBRN。应考虑在MCP关节水平同时移位两支示指SBRN分支以改善大小匹配。相应的指神经在SBRN取材水平近侧1 cm处切断。
