Nerve Transfer Surgery for Penetrating Upper Extremity Injuries

Karamanos, Efstathios; Rakitin, Ilya; Dream, Sophie; Siddiqui, Aamir

doi:10.7812/tpp/17-156

Cited by 10 publications

(7 citation statements)

References 14 publications

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“…Disadvantages: It takes about several months for clinical results after the nerve transfer and it demands technical expertise. It is a quite expensive method and availability of donor limits its validation 97. By considering the drawbacks, nerve transfer cannot be taken as a standard treatment method.…”

Section: Disadvantages Of Nerve Repairmentioning

confidence: 99%

Current Status of Therapeutic Approaches against Peripheral Nerve Injuries: A Detailed Story from Injury to Recovery

Hussain¹,

Wang²,

Rasul³

et al. 2020

Int. J. Biol. Sci.

167

175

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Peripheral nerve injury is a complex condition with a variety of signs and symptoms such as numbness, tingling, jabbing, throbbing, burning or sharp pain. Peripheral nerves are fragile in nature and can easily get damaged due to acute compression or trauma which may lead to the sensory and motor functions deficits and even lifelong disability. After lesion, the neuronal cell body becomes disconnected from the axon's distal portion to the injury site leading to the axonal degeneration and dismantlement of neuromuscular junctions of targeted muscles. In spite of extensive research on this aspect, complete functional recovery still remains a challenge to be resolved. This review highlights detailed pathophysiological events after an injury to a peripheral nerve and the associated factors that can either hinder or promote the regenerative machinery. In addition, it throws light on the available therapeutic strategies including supporting therapies, surgical and non-surgical interventions to ameliorate the axonal regeneration, neuronal survival, and reinnervation of peripheral targets. Despite the availability of various treatment options, we are still lacking the optimal treatments for a perfect and complete functional regain. The need for the present age is to discover or design such potent compounds that would be able to execute the complete functional retrieval. In this regard, plant-derived compounds are getting more attention and several recent reports validate their remedial effects. A plethora of plants and plant-derived phytochemicals have been suggested with curative effects against a number of diseases in general and neuronal injury in particular. They can be a ray of hope for the suffering individuals.

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Section: Disadvantages Of Nerve Repairmentioning

confidence: 99%

Current Status of Therapeutic Approaches against Peripheral Nerve Injuries: A Detailed Story from Injury to Recovery

Hussain¹,

Wang²,

Rasul³

et al. 2020

Int. J. Biol. Sci.

167

175

View full text Add to dashboard Cite

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“…There is also a long history of surgical repair via autologous nerve bridges and via a wide variety of conduits that include acellular allografts [ 61 , 62 , 63 , 64 ]. Other important surgical procedures in practice are (1) the nerve transfer of either a redundant proximal nerve stump or dissected fascicles of a functioning nerve to a denervated distal stump to restore function [ 65 , 66 , 67 , 68 , 69 ] and (2) the transfer of tendons to assist lost movements [ 70 ]. The use of stem cells such as mesenchymal stem cells as substitutes for SCs is also being explored in animal models [ 71 , 72 ].…”

Section: Introductionmentioning

confidence: 99%

Peripheral Nerve Regeneration and Muscle Reinnervation

Gordon

2020

IJMS

203

144

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Injured peripheral nerves but not central nerves have the capacity to regenerate and reinnervate their target organs. After the two most severe peripheral nerve injuries of six types, crush and transection injuries, nerve fibers distal to the injury site undergo Wallerian degeneration. The denervated Schwann cells (SCs) proliferate, elongate and line the endoneurial tubes to guide and support regenerating axons. The axons emerge from the stump of the viable nerve attached to the neuronal soma. The SCs downregulate myelin-associated genes and concurrently, upregulate growth-associated genes that include neurotrophic factors as do the injured neurons. However, the gene expression is transient and progressively fails to support axon regeneration within the SC-containing endoneurial tubes. Moreover, despite some preference of regenerating motor and sensory axons to “find” their appropriate pathways, the axons fail to enter their original endoneurial tubes and to reinnervate original target organs, obstacles to functional recovery that confront nerve surgeons. Several surgical manipulations in clinical use, including nerve and tendon transfers, the potential for brief low-frequency electrical stimulation proximal to nerve repair, and local FK506 application to accelerate axon outgrowth, are encouraging as is the continuing research to elucidate the molecular basis of nerve regeneration.

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“…3 Neste procedimento, ramos de um nervo vizinho são retirados e redirecionados para a extremidade distal do nervo danificado. 4 Depois da cirurgia, há regeneração dos axônios da nova via e reconexão do córtex motor para reaprendizado das funções musculares. 4 Há diversos relatos experimentais nos quais o aloenxerto de nervo foi usado como alternativa ao autoenxerto para união de duas extremidades de um nervo em seres humanos e outros primatas.…”

Section: Introductionunclassified

“…4 Depois da cirurgia, há regeneração dos axônios da nova via e reconexão do córtex motor para reaprendizado das funções musculares. 4 Há diversos relatos experimentais nos quais o aloenxerto de nervo foi usado como alternativa ao autoenxerto para união de duas extremidades de um nervo em seres humanos e outros primatas. 5 O tecido do aloenxerto atuaria como suporte temporário para maior regeneração neural, dando as características estruturais essenciais do tecido nervoso.…”

Section: Introductionunclassified

Enxerto e transferência de nervo para melhora da flexão do cotovelo em crianças com paralisia obstétrica. Uma revisão sistemática

Velásquez-Girón

Zapata-Copete

2021

Rev Bras Ortop (Sao Paulo)

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ResumoA paralisia obstétrica do plexo braquial é uma lesão bastante comum em neonatos, sendo causada pela tração do plexo braquial durante o trabalho de parto. A presente revisão sistemática tem como objetivo explorar o uso de enxertos e transferências de nervo como procedimentos para melhora da flexão do cotovelo em crianças com paralisia obstétrica. A presente revisão sistemática seguiu as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, na sigla em inglês) e foi baseada em pesquisa nos bancos de dados MEDLINE, EMBASE, LILACS, The Cochrane Central Register of Controlled Trials, Web of Science, Wholis e SCOPUS. De acordo com os critérios pré-determinados, os artigos incluídos eram ensaios clínicos, quase-experimentos, e estudos de coortes sobre enxertos e transferências de nervos em crianças (de até 3 anos de idade) com diagnóstico de paralisia obstétrica. A ferramenta de avaliação Risk of Bias in Non-Randomized Studies of Interventions foi usada em estudos não randomizados. Sete estudos utilizaram os dois procedimentos; três deles compararam os procedimentos de enxerto e transferência de nervo, enquanto os outros quatro os combinaram como método reconstrutivo em crianças com paralisia obstétrica. Segundo o sistema de classificação do Medical Research Council, os dois métodos melhoraram a flexão do cotovelo das crianças de maneira similar. De modo geral, nossos resultados mostraram que o enxerto de nervo e a transferência de nervo são opções igualmente boas para a reconstrução nervosa em casos de paralisia obstétrica. Mais estudos sobre as técnicas de reconstrução nervosa na paralisia obstétrica devem ser realizados, de preferência ensaios clínicos randomizados, para validação dos resultados dessa revisão sistemática.

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Nerve Transfer Surgery for Penetrating Upper Extremity Injuries

Cited by 10 publications

References 14 publications

Current Status of Therapeutic Approaches against Peripheral Nerve Injuries: A Detailed Story from Injury to Recovery

Current Status of Therapeutic Approaches against Peripheral Nerve Injuries: A Detailed Story from Injury to Recovery

Peripheral Nerve Regeneration and Muscle Reinnervation

Enxerto e transferência de nervo para melhora da flexão do cotovelo em crianças com paralisia obstétrica. Uma revisão sistemática

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