Distal Nerve Transfer to Restore Wrist and Finger Extension – A Systematic Review

Garg, Varun; Regmi, Anil; Negi, Naveen Kumar; Yasam, Rama Priya; Sinha, Shandip Kumar; Singh, Vivek Kumar

doi:10.1142/s2424835522500953

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…Humeral fractures and iatrogenic insults account for most radial nerve injuries in the arm ( 52 ), resulting in loss of wrist, finger and thumb extension. A systemic review by Garg et al ( 52 ) reviewed the outcome of 7 articles (of level IV and V evidence) with a total of 28 patients following distal nerve transfer of median nerve branches to restore wrist and finger extension respectively. A proportion of 96% (n=27) had high radial nerve palsy and one had low radial nerve involvement.…”

Section: Nerve Transfers For Radial Ulnar and Median Nerve Injuriesmentioning

confidence: 99%

Updates in peripheral nerve surgery of the upper extremity: diagnosis and treatment options

Tan,

Jeyaratnam,

Lim

2023

Ann Transl Med

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The loss of function resulting from peripheral nerve injuries confers a significant burden to the patient and society. The treatment of peripheral nerve injuries requires an accurate diagnosis and formulation of a functional reconstructive plan. Advances in peripheral nerve imaging complement electrodiagnostic studies, and provide us with detailed information regarding the status of nerve injury, repair, and regeneration in order to prognosticate recovery and determine the need for surgical intervention. When direct nerve repair is not possible, the methods for bridging a nerve gap are the nerve autograft, allograft and conduit. While current research supports the use of conduits and nerve allografts for shorter nerve gaps, the nerve autograft still remains the gold standard for bridging a nerve gap. When direct nerve repair or nerve grafting fails, or is anticipated to be insufficient, nerve transfers are an alternative for reconstruction. Knowledge of axonal counts, upper limb innervation patterns, location and clustering of upper limb peripheral nerves allows for the design of new nerve transfers. The options of nerve transfers for radial, ulnar and median nerve injuries are outlined, as well as their outcomes. Nerve transfers are an attractive option for restoring motor and sensory function while minimizing donor site morbidity. However, one must consider their limitations, and preserve donor sites for secondary tendon transfer options. This article presents the latest information regarding the imaging of peripheral nerves, methods to bridge a nerve gap, and nerve transfers to aid the peripheral nerve surgeon in choosing a reconstructive plan.

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Section: Nerve Transfers For Radial Ulnar and Median Nerve Injuriesmentioning

confidence: 99%

Updates in peripheral nerve surgery of the upper extremity: diagnosis and treatment options

Tan,

Jeyaratnam,

Lim

2023

Ann Transl Med

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“…Garg et al and Yang et al both demonstrated in systematic reviews that nerve transfer is superior to traditional root nerve grafting in upper brachial plexus injuries (14,16). However, other similar systematic reviews comparing nerve transfer to traditional reconstructive techniques in obturator, tibial, axillary, and radial nerve injuries found traditional reconstructive techniques and nerve transfers had comparable results (49)(50)(51)(52)(53).…”

Section: Indications and Timing For Nerve Transfer Surgerymentioning

confidence: 99%

Assessment, patient selection, and rehabilitation of nerve transfers

Bateman,

Larocerie-Salgado,

Ross

et al. 2023

Front. Rehabil. Sci.

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Peripheral nerve injuries are common and can have a devastating effect on physical, psychological, and socioeconomic wellbeing. Peripheral nerve transfers have become the standard of care for many types of peripheral nerve injury due to their superior outcomes relative to conventional techniques. As the indications for, and use of, nerve transfers expand, the importance of pre-operative assessment and post-operative optimization increases. There are two principal advantages of nerve transfers: (1) their ability to shorten the time to reinnervation of muscles undergoing denervation because of peripheral nerve injury; and (2) their specificity in ensuring proximal motor and sensory axons are directed towards appropriate motor and sensory targets. Compared to conventional nerve grafting, nerve transfers offer opportunities to reinnervate muscles affected by cervical spinal cord injury and to augment natural reinnervation potential for very proximal injuries. This article provides a narrative review of the current scientific knowledge and clinical understanding of nerve transfers including peripheral nerve injury assessment and pre- and post-operative electrodiagnostic testing, adjuvant therapies, and post-operative rehabilitation for optimizing nerve transfer outcomes.

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“…However, nerve reconstruction is often needed with the use of grafts to prevent tension in repairs due to nerve gaps. More recently, distal nerve transfers have been introduced as an important addition to the armamentarium of treating nerve gaps (Garg et al., 2022).…”

Section: Introductionmentioning

confidence: 99%

Muscle preservation in proximal nerve injuries: a current update

Lysak,

Farnebo,

Geuna

et al. 2024

J Hand Surg Eur Vol

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Optimal recovery of muscle function after proximal nerve injuries remains a complex and challenging problem. After a nerve injury, alterations in the affected muscles lead to atrophy, and later degeneration and replacement by fat-fibrous tissues. At present, several different strategies for the preservation of skeletal muscle have been reported, including various sets of physical exercises, muscle massage, physical methods (e.g. electrical stimulation, magnetic field and laser stimulation, low-intensity pulsed ultrasound), medicines (e.g. nutrients, natural and chemical agents, anti-inflammatory and antioxidants, hormones, enzymes and enzyme inhibitors), regenerative medicine (e.g. growth factors, stem cells and microbiota) and surgical procedures (e.g. supercharge end-to-side neurotization). The present review will focus on methods that aimed to minimize the damage to muscles after denervation based on our present knowledge.

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Distal Nerve Transfer to Restore Wrist and Finger Extension – A Systematic Review

Cited by 5 publications

References 20 publications

Updates in peripheral nerve surgery of the upper extremity: diagnosis and treatment options

Updates in peripheral nerve surgery of the upper extremity: diagnosis and treatment options

Assessment, patient selection, and rehabilitation of nerve transfers

Muscle preservation in proximal nerve injuries: a current update

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