Nerve transfer of the anterior interosseous nerve to the thenar branch of the median nerve – an anatomical and histological analysis

Frank, Konstantin; Englbrecht, Marc A; Koban, Konstantin Christoph; Cotofana, Sebastian; Stewart, Jessica K.; Giunta, Riccardo E.; Schenck, Thilo L.

doi:10.1016/j.bjps.2018.12.017

Cited by 9 publications

(8 citation statements)

References 26 publications

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“…Frank et al () reported direct nerve transfer between the anterior interosseous nerve of forearm (AIN) and the RMN. Multiple inherent limitations are associated with this technique, as use of the distal AIN should only performed when the AIN is not injured, that is, only distal median nerve injuries (Bertelli, Soldado, Lehn, & Ghizoni, ).…”

Section: Discussionmentioning

confidence: 99%

“…The authors reported requiring a 4-cm graft to bridge the gap between the branch to the extensor indicis and the RMN, which creates two coaptations for regenerating axons to cross; they also noted the potential for creating new sensory deficits in harvesting autologous nerve graft. Frank et al (2019) reported direct nerve transfer between the anterior interosseous nerve of forearm (AIN) and the RMN. Multiple inherent limitations are associated with this technique, as use of the distal AIN should only performed when the AIN is not injured, that is, only distal median nerve injuries (Bertelli, Soldado, Lehn, & Ghizoni, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Transfer of redundant or expendable nerves to the motor branches of denervated muscles has yielded substantial return of movement and motor strength, reversal of atrophy, and patient utility. The advantages of distal nerve transfers over nerve repair or nerve grafting include more rapid recovery of function, limited antagonistic co‐contraction, and the absence of sensory axon to motor target regeneration, among others (Bertelli et al, ; Frank et al, ; MacAvoy & Green, ; Schultz & Aiache, ; Wang et al, ; Wang & Zhu, ).…”

Section: Introductionmentioning

confidence: 99%

“…Nerve transfers distal to the injury have demonstrated substantial success in reanimating denervated muscles (Bertelli, Soldado, Rodrigues-Baeza, & Ghizoni, 2018;Frank et al, 2019;MacAvoy & Green, 2007;Schultz & Aiache, 1972;Wang et al, 2017;Wang & Zhu, 1997). Transfer of redundant or expendable nerves to the motor branches of denervated muscles has yielded substantial return of movement and motor strength, reversal of atrophy, and patient utility.…”

Section: Introductionmentioning

confidence: 99%

“…The advantages of distal nerve transfers over nerve repair or nerve grafting include more rapid recovery of function, limited antagonistic co-contraction, and the absence of sensory axon to motor target regeneration, among others (Bertelli et al, 2018;Frank et al, 2019;MacAvoy & Green, 2007;Schultz & Aiache, 1972;Wang et al, 2017;Wang & Zhu, 1997).…”

Section: Introductionmentioning

confidence: 99%

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Distal nerve transfer for thenar palsy: A cadaveric study

et al. 2020

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Introduction Severe proximal median nerve palsies often result in irreversible thenar atrophy and thumb abduction function loss. Tendon transfer involves substantial limitations and challenges; but, distal nerve transfer may provide an alternative treatment. Our goal was to validate the anatomical suitability of two distal ulnar nerve branches for thenar muscle reanimation. Materials and Methods We assessed nerve transfer to the recurrent branch of median nerve (RMN) in 16 embalmed cadaveric hands. The ulnar motor branch to the flexor digiti minimi brevis (FDMBn) and the ulnar motor branch to the third lumbrical (3rdLn) were assessed for transfer. Coaptation success was measured by the overlap of the nerve donor with the RMN and correspondence of nerve diameters. Results The mean transferable length and width of the RMN were 20.7 ± 4.5 and 1.0 ± 0.3 mm, respectively. We identified an average of three branches in the branching anatomy from the ulnar nerve to the hypothenar muscles. The maximal transferable lengths and widths of the FDMBn and the 3rdLn were 13.8 ± 4.4 and 0.5 ± 0.1 mm and 24.1 ± 6.4 and 0.4 ± 0.1 mm, respectively. The overlap with the RMN of the FDMBn and 3rdLn was 9.0 ± 3.6 (2.0–15.3) and 17.8 ± 6.0 (4.7–27.5) mm, respectively. Conclusions This anatomical study demonstrates the feasibility of distal nerve transfers between the ulnar and median nerves in the hand for reanimation of thenar muscles. Ulnar motor donors of the BrFDMBn and 3rdLn likely represent the least morbid donors with short distances for regeneration and a single coaptation repair.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Distal nerve transfer for thenar palsy: A cadaveric study

et al. 2020

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Efficacy evaluation of personalized coaptation in neurotization for motor deficit after peripheral nerve injury: A systematic review and meta‐analysis

Qian

et al. 2020

Brain and Behavior

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Introduction: Peripheral neurotization, recently as a promising approach, has taken effect in recovering motor function after damage to a peripheral nerve root. Neural anastomosis comprised of nerve conduit and neurorrhaphy participates in the nerve reconstruction. Current literature lacks evidence supporting an individualized coaptation for rescue of locomotor loss in rat subjects with paraplegia secondary to peripheral nerve injury (PNI). Methods:This meta-analysis intends to qualify the specificity of gap-specific coaptation in treating a paralyzed limb following PNI. We used a highly sensitive search strategy to identify all published studies in multiple databases up to 1 May 2019. All identified trials were systematically evaluated using specific inclusion and exclusion criteria. Cochrane methodology was also applied to the results of this study.Results: Twelve studies, including 349 rat subjects, met eligibility criteria. For a medium nerve defect (0.5-3.0 cm), nerve conduit was more likely than neurorrhaphy to precipitate axon regeneration and improve motor outcome of the hemiplegic limb (OR = 3.61, 95% CI = 1.80, 7.26, p < .0003) at 3-month follow-up, whereas neurorrhaphy might take its place in promoting limb motor function in a small nerve gap (<0.5 cm) (OR = 0.48, 95% CI = 0.22, 1.07, p < .007). For a small nerve defect, nerve conduit still demonstrated visible effectiveness in recovery of limb motion albeit poorer than neurorrhaphy (OR = 1.50, 95% CI = 0.92, 2.47, p < .05). Conclusion: Selective neurotization facilitates motor regeneration after nerve transection, and advisable choice of neural coaptation can maximize functional outcome on an individual basis. K E Y W O R D S functional recovery, neurotization, neurotube, peripheral nerve injury, personalized coaptation

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Étude anatomique sur le lambeau de carré pronateur pédiculé réinnervé pour réanimer l’opposition du pouce et application clinique

Rouanet

Letissier

et al. 2022

Annales de Chirurgie Plastique Esthétique

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Nerve transfer of the anterior interosseous nerve to the thenar branch of the median nerve – an anatomical and histological analysis

Cited by 9 publications

References 26 publications

Distal nerve transfer for thenar palsy: A cadaveric study

Distal nerve transfer for thenar palsy: A cadaveric study

Efficacy evaluation of personalized coaptation in neurotization for motor deficit after peripheral nerve injury: A systematic review and meta‐analysis

Étude anatomique sur le lambeau de carré pronateur pédiculé réinnervé pour réanimer l’opposition du pouce et application clinique

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