gms | German Medical Science

49. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie (ÖGPÄRC), 42. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen e. V. (DGPRÄC), 16. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen e. V. (VDÄPC)

29.09. - 01.10.2011, Innsbruck

Superficial branch of the radial nerve (RSNR) for regaining sensibility of the ulnar palm and digits

Meeting Abstract

  • author Thilo Schenk - Department of Plastic and Hand Surgery, Technische Universität München, Munich, Germany
  • J. Stewart - Department of Plastic and Hand Surgery, Technische Universität München, Munich, Germany
  • H. Grube - Institute of Anatomy, Medizinische Universität Wien, Vienna Austria
  • H.-G. Machens - Department of Plastic and Hand Surgery, Technische Universität München, Munich, Germany
  • R.E. Giunta - Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians Universität München, Munich, Germany

Österreichische Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie. Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen. Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen. 49. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie (ÖGPÄRC), 42. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 16. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC). Innsbruck, 29.09.-01.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgpraecP106

DOI: 10.3205/11dgpraec290, URN: urn:nbn:de:0183-11dgpraec2909

Published: September 27, 2011

© 2011 Schenk et al.
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Outline

Text

Introduction: Treatment of high-grade nerve injuries of the upper extremity remains a surgical challenge. In the last decade extra-anatomic reconstructions by transferring peripheral nerves have gained importance. It allows nerve transfer distally from the lesion which shortens the reinnveration time. A group of motor nerve transfers to regain motor function of the hand has been described. Although tactile information is crucial for adequate hand function, only few attempts of sensory nerve transfers are known. This contribution introduces a nerve transfer to regain sensibility of the ulnar palm and digits by transferring the superficial branch of the radial nerve (RSNR) to the superficial branch of the ulnar nerve (RSNU).

Materials and methods: The (RSNR) and the (RSNU) where identified in 20 cadavers and the nerve transfer performed. A favourable site for coaptation was chosen and its location described using relevant anatomical landmarks.

Results: Our results indicate that the RSNR is a suitable donor for the RSNU. The RSNR should be dissected at the height of its diversion into two smaller branches which is found at 21.8 ± 2.8 cm distal of the lateral epicondyle of the humerus. Harvesting it proximal of its diversion maximizes the number of axons. Maximal length of the RSNR is achieved by placing it between the superficial and deep flexors. In this way its end reaches a position 5 mm proximal to the RSNU. In order to coapt the nerves, the RSNU has to be separated retrograde from the deep branch of the ulnar nerve over a distance of approximately 5 mm measured from their division. We recommend this point as suitable site of coaptation. It is located 5 mm proximal of the pisiform bone.

Conclusions: Our measurements show feasibility of this procedure and shall help in planning this sensory nerve transfer.