RESUMEN
OBJECTIVE: To demonstrate the new sensory restoration technique in radial nerve injury using the first branch of dorsal ulnar cutaneous nerve as the donor sensory nerve. MATERIAL AND METHOD: Forty formalin-preserved cadavers (18 males and 22 females) were used as the subjects of the present study. The localization of the origin of first branch of dorsal ulnar cutaneous nerve was performed. The measurement was done to determine the origin of this nerve in relation to the tip of ulnar styloid. The simulated transfer was done. The length of the superficial radial nerve that had to be cut was determined. The measurement was done by two observers to determine the reliability of measurement. RESULTS: The mean horizontal distance (X) to the origin of first branch of dorsal ulnar cutaneous nerve measured from the tip of ulnar styloid on the right and left side were 5.22 mm and 6.51 mm respectively. The mean vertical distance (Y) to the origin of first branch of dorsal ulnar cutaneous nerve measured from the tip of ulnar styloid on the right and left side were -7.72 mm and -4.37 mm respectively. The mean length of superficial radial nerve that had to be cut to allow tension free anastomosis, measured from the tip of radial styloid on the right and left side were 68.21 mm and 65.92 mm respectively. The estimated average size of the transferred branch of ulnar cutaneous nerve was about 70% of the size of superficial radial nerve. CONCLUSION: The sensory restoration in radial nerve injury using sensory nerve transfer from the first branch of dorsal ulnar cutaneous nerve was technically feasible regarding to the comparable size between two nerves and anatomic consistency of the first branch of dorsal ulnar cutaneous nerve.
Asunto(s)
Traumatismos del Antebrazo/complicaciones , Traumatismos del Antebrazo/cirugía , Transferencia de Nervios/métodos , Traumatismos de los Nervios Periféricos/cirugía , Nervio Radial/lesiones , Sensación , Cadáver , Estudios de Factibilidad , Femenino , Antebrazo/inervación , Traumatismos del Antebrazo/fisiopatología , Humanos , Laceraciones/cirugía , Masculino , Nervio Mediano/lesiones , Recuperación de la Función , Nervio Cubital/trasplanteRESUMEN
The superficial peroneal nerve (SPN) is one of the two main branches of the common peroneal nerve, which become cutaneous nerve on the lateral side of distal leg and dorsum of foot. The use of SPN as nerve graft has been introduced; however, important data regarding the morphometric anatomy of this nerve and its branches, medial and intermediate dorsal cutaneous nerves (MDN and IDN, respectively) to support this application remain incomplete. Eighty-five legs of cadavers were dissected and the branching pattern was classified into Type 1 (penetration of the main trunk of SPN from the deep fascia) or Type 2 (separate penetration of the MDN and IDN). The length of SPN, MDN and IDN from the penetration points until before subsequent branching was measured. In addition, the penetration points were located by referring to the intermalleolar line and the lateral malleolus. Type 1 was found in the majority of specimens independent of gender (71.8%). Asymmetry in the branching pattern was observed in nine cases (20.9%). The average length of the SPN, MDN and IDN without branches was 7.7, 8.1 and 5.5 cm, respectively. The penetration points of the SPN, MDN and IDN were located 5.1, 7.6 and 5.5 cm above the intermalleolar line, respectively. These data are important for using the SPN as a graft.