背景:尽管一些研究报道了供体自体神经移植物治疗指神经缺损,文献中没有关于拇指神经可接受移植物的报道。这项研究的目的是通过检测拇指神经区和供体神经之间在束数和横截面积方面的相似性,为自体神经移植物的选择提供指南。
方法:本研究使用5具尸体。为拇指神经(区域1、2、3)定义了解剖分区系统。腓肠神经(SN),前臂内侧皮神经(MABCN),前臂外侧皮神经(LABCN),骨间后神经(PIN),选择骨间前神经(AIN)作为供体神经移植物。定义了纤维束的数量和表面积(mm2)。
结果:区域1,区域2,区域3,AIN,PIN,LABCN,MABCN,SN分别为3.8、4.7、6.1、2.2、1.8、4.5、3.1和6.4。区域1、区域2、区域3、AIN、PIN,LABCN,MABCN,SN分别为2.19、6.26、4.04、1.58、0.71、5.00、3.01和8.06。
结论:LABCN是与拇指神经的所有三个区域都具有束状匹配以及与区域2和3匹配的口径的所有区域的最佳选择。在第1区中,最好的神经移植物是MABCN,其具有合适的口径和束计数。
BACKGROUND: Even though several studies reported donor autologous nerve grafts for digital nerve defects, there is no report in the literature regarding acceptable graft for thumb nerves. The purpose of this study is to provide guidelines for autologous nerve graft selection by detecting similarities between thumb nerve zones and donor nerve with regard to the number of fascicles and cross-sectional area.
METHODS: Five cadavers were used in this study. An anatomical zoning system was defined for thumb nerves (zones 1, 2, 3). Sural nerve (SN), medial antebrachial cutaneous nerve (MABCN), lateral antebrachial cutaneous nerve (LABCN), posterior interosseous nerve (PIN), and anterior interosseous nerve (AIN) were selected as donor nerve grafts. The number of fascicles and surface area (mm2) was defined.
RESULTS: The mean of the fascicle number in zone 1, zone 2, zone 3, AIN, PIN, LABCN, MABCN, and SN were 3.8, 4.7, 6.1, 2.2, 1.8, 4.5, 3.1, and 6.4, respectively. The mean of the surface area in zone 1, zone 2, zone 3, AIN, PIN, LABCN, MABCN, and SN were 2.19, 6.26, 4.04, 1.58, 0.71, 5.00, 3.01, and 8.06, respectively.
CONCLUSIONS: LABCN is the best choice for all zones that has fascicular matching with all three zones of thumb nerves and caliber matching with zones 2 and 3. In zone 1, the best nerve graft is MABCN which has both suitable caliber and fascicle count.