Kodama Akira, Kunisaki Atsushi, Tanaka Teruyasu, Ishibashi Shigeki, Tsuji Kentarou, Munemori Masaru, Kamei Goki, Ikegami Koji, Adachi Nobuo
Division of Regenerative Medicine for Musculoskeletal System Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
PLoS One. 2025 May 5;20(5):e0322331. doi: 10.1371/journal.pone.0322331. eCollection 2025.
This study aimed to histologically investigate whether the compatibility of donor and recipient nerves in distal nerve transfer for radial and ulnar nerve palsy is suitable for restoring nerve function. Partial median to radial nerve transfer for radial nerve palsy and partial median to ulnar nerve transfer for ulnar nerve palsy were performed in 10 cadaveric upper limbs fixed using the Thiel technique. Histological analysis of the nerve samples at the coaptation site focused on the number of myelinated axons. Each recipient and donor nerve was identified in all specimens without any anatomical variations. While median-radial nerve transfer techniques showed an adequate number of donor axons, median-ulnar nerve transfer techniques showed a shortage of donor axons. The insufficiency of donor axons compared to the recipient axons may explain the challenges in reinnervating the recipient muscles. Combining the two different nerve transfers may compensate for the shortage of donor axons and improve motor recovery. Type of study and Level of evidence: Therapeutic, Level III.
本研究旨在通过组织学方法调查在桡神经和尺神经麻痹的远端神经转移中，供体神经与受体神经的相容性是否适合恢复神经功能。在10具采用蒂尔技术固定的尸体上肢中，进行了部分正中神经至桡神经转移治疗桡神经麻痹，以及部分正中神经至尺神经转移治疗尺神经麻痹。对吻合部位神经样本的组织学分析集中于有髓轴突的数量。在所有标本中均能识别出每条受体神经和供体神经，且无任何解剖变异。虽然正中神经至桡神经转移技术显示有足够数量的供体轴突，但正中神经至尺神经转移技术显示供体轴突短缺。与受体轴突相比，供体轴突不足可能解释了在使受体肌肉重新获得神经支配方面存在的挑战。将两种不同的神经转移方法结合起来可能弥补供体轴突的短缺并改善运动恢复。研究类型和证据水平：治疗性研究，III级。
