Journal
HAND SURGERY & REHABILITATION
Volume 36, Issue 4, Pages 296-300Publisher
ELSEVIER
DOI: 10.1016/j.hansur.2017.05.003
Keywords
Innervation; Nerve transfer; Brachial plexus palsy
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In the context of lower (C8-T1) brachial plexus injury, transfer of the lateral antebrachial cutaneous nerve (LABCN) to the dorsal branch of the ulnar nerve (DBUN) with an interposed sural nerve graft has been proposed to restore sensitivity on the ulnar side of the hand. The purpose of this study was to assess the feasibility of performing this transfer directly - without interpositioh of a nerve graft - by intraneural dissection of the DBUN. An anatomical study was performed with 20 upper limbs from adult human cadavers. The LABCN and the DBUN were dissected. The LABCN emerged from the lateral side of the biceps brachii muscle at an average of 2.6 +/- 0.4 cm from the interepicondylar line and was 13.5 +/- 2.6 cm long, on average. The DBUN arose from the ulnar nerve 8.2 +/- 1.6 cm from the styloid process of the ulna. The maximum length of DBUN intraneural dissection relative to the ulnar nerve was 7.5 +/- 2.1 cm, on average. The LABCN could be transferred to the DBUN in a tension-free manner with end-to-end suturing. Intraneural dissection of the DBUN allows LABCN nerve transfer without interposition of a graft. (C) 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.
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