TRANSFER OF AXILLARY NERVE BRANCHESTO RECONSTRUCT ELBOW EXTENSION IN TETRAPLEGICS:A LABORATORY INVESTIGATION OF SURGICAL FEASIBILITY
In spinal cord injuries at the C6 level, elbow extension is lost and needs reconstruction. Traditionally, elbow extensionhas been recon structed by muscle transfers, which improve function only moderately. We have hypothesized that outcomescould be ameliorated by nerve transfers rather than muscle transfers. We anatomically investigated nerve branchesto the teres minor and posterior deltoid as donors for transfer to triceps motor branches. In eight formalin-fixed cadavers,the axillary nerve, the teres minor branch, the posterior deltoid branch, the triceps long and upper medial head motorbranches, and the thoracodorsal nerve were dissected bilaterally, their diameters measured and their myelinated fiberscounted. To simulate surgery, using an axillary approach in two fresh cadavers, we transferred the teres minor or the posteriordeltoid branch to the triceps long head and to the thoracodorsal nerve. The posterior division of the axillary nerve gaveoff the teres minor motor branch and then the branch to the posterior deltoid, terminating as the superior lateral brachialcutaneous nerve. The diameters of the teres minor motor branch, posterior deltoid, triceps long and upper medial headbranches, and the thoracodorsal nerve all were ~ 2 mm, with minimal variation. The nerves varied little in their numbers ofmyelinated fibers, being consistently about 1,000. Via an axillary approach, either the teres minor or the posterior deltoidbranch could be transferred directly to the thoracodorsal nerve or to triceps branches without any tension.
Keywords
тетраплегия,
подмышечный нерв,
локтевой сустав,
tetraplegia,
n. axillaris,
elbowAuthors
| Bertelli J. A. | | e-mail: baitinger@mail.tomsknet.ru |
| Tacca C. P. | | |
| Duarte E. C. W. | | |
| Ghizoni M. F. | | |
| Duarte H. | | |
Всего: 5
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