Chen Xi, Lao Jie, Rui Jing
Department of Hand Surgery, Huashan Hospital, Fudan University, P. R. China.
NHC Key Laboratory of Hand Reconstruction (Fudan University), P. R. China.
J Hand Surg Eur Vol. 2025 Jul 11:17531934251356901. doi: 10.1177/17531934251356901.
Traditional contralateral seventh cervical nerve root (C7) transfer sacrifices the recovery of ulnar nerve. This cadaveric study, done in 20 upper extremities from 10 cadavers, looks at the feasibility of using a modified contralateral C7 transfer using lateral antebrachial cutaneous nerve to allow recovery of ulnar nerve. The deep branch of ulnar nerve was preserved with ipsilateral lateral antebrachial cutaneous nerve, while the distal end of ulnar nerve with its dorsal and superficial branches was transferred to contralateral C7 nerve root and the proximal end of ulnar nerve was anastomosed to both median and musculocutaneous nerves. The ipsilateral lateral antebrachial cutaneous nerve was separated and coapted with motor branch of ulnar nerve. The distance from the midpoint of connection of medial and lateral epicondyles of humerus (interepicondylar line) to the starting point of deep branch of ulnar nerve was significantly shorter than that to the branching point of the lateral antebrachial cutaneous nerve (0.05). The differences in diameters between deep branch of ulnar nerve and main trunk and branches of lateral antebrachial cutaneous nerve were not significant ( > 0.05). The ratio of ulnar nerve axon count to combined total axon count of musculocutaneous nerve, main trunk of lateral antebrachial cutaneous nerve and branches to deep branch of ulnar nerve were above 1:3. In conclusion, the deep branch of ulnar nerve could be restored with lateral antebrachial cutaneous nerve, while contralateral C7 was transferred to median and musculocutaneous nerves through grafts of dorsal and superficial branches of ulnar nerve.
传统的对侧第七颈神经根（C7）移位会牺牲尺神经的恢复。这项尸体研究对10具尸体的20个上肢进行，探讨了使用改良的对侧C7移位并结合前臂外侧皮神经以实现尺神经恢复的可行性。尺神经深支与同侧前臂外侧皮神经保留，而尺神经远端及其背侧和浅支被转移至对侧C7神经根，尺神经近端与正中神经和肌皮神经均进行吻合。同侧前臂外侧皮神经分离后与尺神经运动支进行接合。从肱骨内、外上髁连线中点（髁间线）至尺神经深支起始点的距离显著短于至前臂外侧皮神经分支点的距离（P<0.05）。尺神经深支与前臂外侧皮神经主干及分支的直径差异无统计学意义（P>0.05）。尺神经轴突计数与肌皮神经、前臂外侧皮神经主干及尺神经深支分支的总轴突计数之和的比值大于1:3。总之，尺神经深支可通过前臂外侧皮神经得以恢复，而对侧C7通过尺神经背侧和浅支的移植转移至正中神经和肌皮神经。
