Background Knowledge on the anatomical and morphological characteristics of the superficial peroneal nerve is amenable to further refinement. This cadaveric study aimed to further evaluate anatomical and morphological characteristics of the superficial peroneal nerve. Methods In this study, 10 lower limbs from five fresh cadavers were dissected. The anatomical characteristics of the superficial peroneal nerve were identified. Nerve segments were submitted for histological and morphometric analyses, and nerve thicknesses and number of fascicles were assessed. Results Regarding the superficial peroneal nerve's bifurcation, 80% of the terminal branches were distal to the point of emergence from the fascia. In 90% limbs, two sensory branches were observed immediately after the distal bifurcation of the superficial peroneal nerve. The mean distance from the fibular head to the superficial peroneal nerve's emergence from the fascia was 24.6 cm and mean nerve thickness at this point was 0.3 cm. The mean distance between the lateral malleolus and the main nerve trunk at the ankle was 4.68 cm. The mean distance from the motor branch of the peroneus brevis to the lateral malleolus was 29.3 cm. Morphometric analyses revealed an average five nerve bundles at the broadest nerve diameter (2.6 mm). Conclusion The anatomical and morphometrical characteristics of the superficial peroneal nerve indicate that it may be a safe and useful donor for autologous graft treatment of peripheral nerve injuries. Our morphological study shows a median of five fascicles, and that the thickest diameter of the nerve was 2.6 mm at the emergence from the deep to the superficial compartment.
Estudo experimental comparativo da ação das neurocinas cardiotrofina-1 e oncostatina-m na regeneração nervosa periférica RESUMO RESUMO RESUMO RESUMO RESUMOOs avanços das técnicas microcirúrgicas e o Os avanços das técnicas microcirúrgicas e o Os avanços das técnicas microcirúrgicas e o Os avanços das técnicas microcirúrgicas e o Os avanços das técnicas microcirúrgicas e o conhecimento detalhado do microambiente da regeneração conhecimento detalhado do microambiente da regeneração conhecimento detalhado do microambiente da regeneração conhecimento detalhado do microambiente da regeneração conhecimento detalhado do microambiente da regeneração podem contribuir significativamente na melhoria dos podem contribuir significativamente na melhoria dos podem contribuir significativamente na melhoria dos podem contribuir significativamente na melhoria dos podem contribuir significativamente na melhoria dos resultados das reparações nervosas periféricas. Nos últimos resultados das reparações nervosas periféricas. Nos últimos resultados das reparações nervosas periféricas. Nos últimos resultados das reparações nervosas periféricas. Nos últimos resultados das reparações nervosas periféricas. Nos últimos anos vários autores têm utilizado uma série de tecidos e anos vários autores têm utilizado uma série de tecidos e anos vários autores têm utilizado uma série de tecidos e anos vários autores têm utilizado uma série de tecidos e anos vários autores têm utilizado uma série de tecidos e substâncias interpostos entre os cotos de um nervo periférico substâncias interpostos entre os cotos de um nervo periférico substâncias interpostos entre os cotos de um nervo periférico substâncias interpostos entre os cotos de um nervo periférico substâncias interpostos entre os cotos de um nervo periférico seccionado, buscando estimular o crescimento axonal no seccionado, buscando estimular o crescimento axonal no seccionado, buscando estimular o crescimento axonal no seccionado, buscando estimular o crescimento axonal no seccionado, buscando estimular o crescimento axonal no local da lesão. local da lesão. local da lesão. local da lesão. local da lesão.Através da técnica de tubulização, os autores estudam o Através da técnica de tubulização, os autores estudam o Através da técnica de tubulização, os autores estudam o Através da técnica de tubulização, os autores estudam o Através da técnica de tubulização, os autores estudam o efeito de duas neurocinas, a cardiotrofina-1 (CT efeito de duas neurocinas, a cardiotrofina-1 (CT efeito de duas neurocinas, a cardiotrofina-1 (CT efeito de duas neurocinas, a cardiotrofina-1 (CT efeito de duas neurocinas, a cardiotrofina-1 (CT-1) e a -1) e a -1) e a -1) e a -1) e a oncostatina-M (OsM), no crescimento axonal e na sobrevida oncostatina-M (OsM), no crescimento axonal e na sobrevida oncostatina-M (OsM), no crescimento axonal e na sobrevida oncostatina-M (OsM), no crescimento axonal e na sobrevida oncostatina-M (OsM), no crescimento axonal e na sobrevida dos neurônios sensitivos nos gânglios da raiz dorsa...
ObjectiveTo evaluate the clinical results from treating chronic peripheral nerve injuries using the superficial peroneal nerve as a graft donor source.MethodsThis was a study on eleven patients with peripheral nerve injuries in the upper limbs that were treated with grafts from the sensitive branch of the superficial peroneal nerve. The mean time interval between the dates of the injury and surgery was 93 days. The ulnar nerve was injured in eight cases and the median nerve in six. There were three cases of injury to both nerves. In the surgery, a longitudinal incision was made on the anterolateral face of the ankle, thus viewing the superficial peroneal nerve, which was located anteriorly to the extensor digitorum longus muscle. Proximally, the deep fascia between the extensor digitorum longus and the peroneal longus muscles was dissected. Next, the motor branch of the short peroneal muscle (one of the branches of the superficial peroneal nerve) was identified. The proximal limit of the sensitive branch was found at this point.ResultsThe average space between the nerve stumps was 3.8 cm. The average length of the grafts was 16.44 cm. The number of segments used was two to four cables. In evaluating the recovery of sensitivity, 27.2% evolved to S2+, 54.5% to S3 and 18.1% to S3+. Regarding motor recovery, 72.7% presented grade 4 and 27.2% grade 3. There was no motor deficit in the donor area. A sensitive deficit in the lateral dorsal region of the ankle and the dorsal region of the foot was observed. None of the patients presented complaints in relation to walking.ConclusionsUse of the superficial peroneal nerve as a graft source for treating peripheral nerve injuries is safe and provides good clinical results similar to those from other nerve graft sources.
The authors report two cases of women with Preiser disease treated with dorsal distal radius vascularized grafts. In the first case, after minor trauma, the patient had pain in the left wrist of insidious onset and evolution with significant worsening. The radiographic examination showed increased density of the proximal pole of the scaphoid, and magnetic resonance imaging (MRI) showed partial necrosis. Intraoperatively, as the integrity of the cartilage of the proximal pole of the scaphoid was observed, dorsal vascularized distal radius graft was performed using the 1,2 intercompartmental supraretinacular artery. In 4 months postoperatively, MRI showed almost total integration of the graft, and 1 year after surgery, the patient was asymptomatic, with normal mobility of the operated wrist and imaging showing a normal scaphoid. The second case had similar history and clinical picture, but the radiographs showed narrowing and diffuse sclerosis and also osteolytic areas in the proximal pole of the scaphoid; MRI showed diffuse necrosis. The same graft technique was used, considering that there was a good cartilaginous coverage of the scaphoid. After 9 years of follow-up, the patients remain free of pain or functional limitations. In such cases, the vascularized graft technique was effective and, therefore, a good therapeutic option, provided that there is no degenerative changes in the carpus and, especially, the cartilage of the proximal pole is viable.
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