Duraku Liron S, Chaudhry Tahseen, George Samuel, Madura Tomas, Zuidam J Michiel, Hundepool Caroline A, Teunis Teun, Baas Martijn, Ramadan Sami, Burahee Abdus S, Power Dominic M
Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, the Netherlands.
Hand and Peripheral Nerve Surgery Department, Queen Elizabeth Hospital, Birmingham, UK.
JPRAS Open. 2024 Jan 18;43:581-594. doi: 10.1016/j.jpra.2024.01.005. eCollection 2025 Mar.
Peripheral nerve injuries to the radial, median, and ulnar nerves have been traditionally treated via direct repair or interposition nerve grafts. Late presentation or failed functional restoration may be salvaged with tendons transfers. Nerve transfers may be deployed either as an adjunct to a proximal reconstruction or as a primary reconstructive strategy, and these techniques are being increasingly adopted as the published evidence matures. The advantages of nerve transfers include shorter reinnervation distances, restoration of original muscle action, and maintenance of independent muscle function. Tendon transfers are reliable, not dependent on time, and the functional use of the limb is often achieved quickly,. Hybrid combinations that combine nerve and tendon transfers can also be used to maximize the recovery potential. This scoping review aimed to provide an overview of nerve transfer possibilities after peripheral nerve injuries and guide management decisions for clinicians treating patients with upper limb paralysis from peripheral nerve injuries.
传统上,桡神经、正中神经和尺神经的周围神经损伤通过直接修复或神经移植进行治疗。晚期就诊或功能恢复失败时,可通过肌腱转移挽救。神经转移既可以作为近端重建的辅助手段,也可以作为主要的重建策略,随着已发表证据的成熟,这些技术正越来越多地被采用。神经转移的优点包括再支配距离短、恢复原始肌肉功能以及维持独立肌肉功能。肌腱转移可靠,不受时间限制,肢体功能通常能很快恢复。将神经和肌腱转移相结合的混合组合也可用于最大限度地提高恢复潜力。本综述旨在概述周围神经损伤后神经转移的可能性,并为治疗上肢周围神经损伤所致瘫痪患者的临床医生提供管理决策指导。