Tubular Repair of the Median Nerve in the Human Forearm

1994 ◽  
Vol 19 (3) ◽  
pp. 273-276 ◽  
Author(s):  
G. LUNDBORG ◽  
B. ROSÉN ◽  
S. O. ABRAHAMSON ◽  
L. DAHLIN ◽  
N. DANIELSEN
Keyword(s):  
Muscle Contraction ◽  
Median Nerve ◽  
Hand Function ◽  
Nerve Trunk ◽  
Contraction Force ◽  
Silicone Tube ◽  
Human Forearm ◽  
Normal Hand ◽  
Male Patients ◽  
Chamber Technique

Transected median nerves in the forearm of two male patients, 12 and 21 years of age, were treated with a chamber technique leaving a 3 to 5 mm gap between the nerve ends. The nerve ends were enclosed in a silicone tube of such a dimension that would not cause compression of the nerve. Post-operative examination including sensory evaluation and assessment of muscle contraction force was carried out after 3 years. In both cases there was excellent motor recovery of the thenar muscles. Outgrowth of sensory fibres was remarkably fast, resulting ultimately in functional sensibility allowing almost normal hand function. 2PD was ⩽ 6 mm (12year-old patient) and 8 to 10 mm (21-year-old patient) respectively. In one case the silicone tube was re-explored because of minor local discomfort 2 years after the repair. The former gap was bridged by a smooth continuous nerve-like structure of the same diameter as the adjacent nerve trunk and with no signs of nenroma formation or compression of the nerve.

Nerve Transfer to the Median Nerve Using Parts of the Ulnar and Radial Nerves in the Rabbit – Effects on Motor Recovery of the Median Nerve and Donor Nerve Morbidity

2000 ◽  
Vol 25 (4) ◽  
pp. 329-335 ◽  
Author(s):  
B. S. LUTZ ◽  
D. C. C. CHUANG ◽  
S. S. CHUANG ◽  
J. C. HSU ◽  
S. F. MA ◽  
...  
Keyword(s):  
Muscle Contraction ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Radial Nerve ◽  
Muscle Power ◽  
Donor Site ◽  
Nerve Transfer ◽  
Donor Site Morbidity ◽  
Motor Recovery ◽  
Contraction Force

In this study, motor re-innervation of the median nerve by transfer of one-third, one-half, and two-thirds of either the agonistic ulnar nerve or the antagonistic radial nerve was investigated in both extremities of 20 rabbits. Recipient median nerve: Muscle contraction force of the flexor digitorum sublimus muscle after a one-third and a one-half of the ulnar nerve transfer achieved an average of 75 and 97% muscle power respectively as compared to conventional end-to-end neurorrhaphy. Muscle contraction force after one-third or one-half of the radial nerve transfer was significantly lower (36%). Donor nerves: Extensor carpi radialis muscle or flexor carpi ulnaris muscle contraction force 6 months postoperatively demonstrated a significant decrease after a one-half ulnar nerve and a two-thirds ulnar or radial nerve transfer, but not after a one-third transfer of either radial or ulnar nerves. Histologically, the number of axons in the re-innervated median nerve and both donor nerves distal to the coaptation site seemed to follow variable patterns. It was concluded that in the rabbit use of one-third of the agonistic ulnar nerve for re-innervation of the median nerve results in useful motor recovery with negligible donor site morbidity. Clinically, this technique may offer an alternative option for proximal nerve injuries or for free functioning muscle transplantations.

Neurilemoma of the Median Nerve - Surgical Strategies Based on a Case Report

2014 ◽  
Vol 86 (9) ◽  
Author(s):  
Łukasz Ulatowski ◽  
Anna Kaniewska
Keyword(s):  
Case Report ◽  
Median Nerve ◽  
Nerve Trunk ◽  
Reconstruction Technique ◽  
Nerve Reconstruction ◽  
Surgical Strategies ◽  
Second Procedure ◽  
Relationship Of ◽  
The Relationship ◽  
Neural Sheath

AbstractThe study presented a case of a patient with a neurilemoma of the median nerve. It presented as a six centemeters tumor, at the level of the proximal one third of the arm with only mild paraesthesias within frst to third ray of the hand. MRI showed the relationship of the tumor and the median nerve, and allowed for the preliminary diagnose of a benign peripheral neural sheath tumor (neurilemoma or neurofibroma). During the first operation the tumor has not been excised, because nerve reconstruction technique was not available. During the second procedure excision of the tumor has been performed without resection of the median nerve trunk with no postoperative deficiencies. The paper provides a detailed description of a surgical procedure. The presented case, like current publications shows that peripheral neural sheath tumor may be usually excised without resection of the nerve trunk, although the possibility of nerve fascicles injury or the need to excise them in the case of neurofibroma clearly suggest that these type of operations should be carried out in centers with microsurgical facilities.

scholarly journals Anterior interosseous nerve syndrome: Fascicular motor lesions of median nerve trunk

Neurology ◽  
2014 ◽  
Vol 82 (7) ◽  
pp. 598-606 ◽  
Author(s):  
M. Pham ◽  
P. Baumer ◽  
H.-M. Meinck ◽  
J. Schiefer ◽  
M. Weiler ◽  
...  
Keyword(s):  
Median Nerve ◽  
Nerve Trunk ◽  
Anterior Interosseous Nerve ◽  
Anterior Interosseous Nerve Syndrome

scholarly journals In vitro muscle contraction force measurements on isolated and entire rat diaphragms

Critical Care ◽  
2010 ◽  
Vol 14 (Suppl 1) ◽  
pp. P204 ◽  
Author(s):  
C Armbruster ◽  
C Dassow ◽  
K Gamerdinger ◽  
J Guttmann ◽  
M Schneider ◽  
...  
Keyword(s):  
Muscle Contraction ◽  
Force Measurements ◽  
Contraction Force

Modeling of Wrist and Hand Motion while Performing Functional Task

2012 ◽  
Vol 433-440 ◽  
pp. 2316-2320
Author(s):  
Ung Eng Ping ◽  
S. Parasuraman
Keyword(s):  
Muscle Contraction ◽  
Vigorous Physical Activity ◽  
Hand Function ◽  
Assessment Procedure ◽  
Data Set ◽  
Hand Motion ◽  
Movement Strategies ◽  
Analysis System ◽  
Initial Results ◽  
Functional Task

A large prescriptive data set of wrist, metacarpal arch fingers and thumb movements has been collected using twenty-four 4mm hemispherical passive reflective markers placed on the wrist, hand and fingers. Movements of each participant were captured by a set of 6-camera infrared motion analysis system (QUALISYS) sampling at 60Hz while undertaking a clinical hand function assessment, the Southampton Hand Assessment Procedure (SHAP). Without Muscle Contraction and With Muscle Contraction versions of objects are assessed and were tested, characteristics of individual movement strategies presented and initial results have shown interesting variations that correspond with physiological and functional approaches to movement. With the whole designed system, patient can improved hand function with the result of vigorous physical activity through the SHAP procedures, from the supervision of researcher can determine the functionality of one patient’s hand and wrist which will benefit subjects with a dramatic effect on one’s daily life as we know exercise is related to better health. Using advanced software such as Visual 3D and Qualisys Tracking Manager, researcher can monitor patient’s recovery progress, with suitable angle of calculation of one’s fingers, acceptable force and velocity of one’s produced depending on age and size of hand of subjects.

Effects Of Thermotherapy And Cryotherapy On Muscle Hypertrophy And Muscle Contraction Force Following Resistance Exercise

2008 ◽  
Vol 40 (Supplement) ◽  
pp. S258 ◽  
Author(s):  
Lucas C. Smith ◽  
Stefan A. Mroczkowski ◽  
Stacey Buser ◽  
Susan Bemis ◽  
Ronald Otterstetter
Keyword(s):  
Resistance Exercise ◽  
Muscle Contraction ◽  
Muscle Hypertrophy ◽  
Contraction Force

scholarly journals Reinnervation of the biceps in C5–7 brachial plexus avulsion injuries: results after distal bypass surgery

2004 ◽  
Vol 16 (5) ◽  
pp. 1-4 ◽  
Author(s):  
Stefano Ferraresi ◽  
Debora Garozzo ◽  
Paolo Buffatti
Keyword(s):  
Brachial Plexus ◽  
Ulnar Nerve ◽  
Hand Function ◽  
Elbow Flexion ◽  
Musculocutaneous Nerve ◽  
Biceps Muscle ◽  
Nerve Transfers ◽  
Significant Difference ◽  
Normal Hand ◽  
Nerve Dysfunction

Object The authors report various techniques, and their results, after performing median and ulnar nerve transfers to reanimate the biceps muscle in C5–7 avulsion-related brachial plexus injuries (BPIs). Methods Forty-three adult patients with BPIs of the upper-middle plexus underwent reinnervation of the biceps muscle; neurotization of the musculocutaneous nerve was performed using fascicles from the ulnar nerve (39 cases) and the median nerve (four cases). The different techniques included sectioning, rerouting, and direct suturing of the entire musculocutaneous nerve (35 cases); direct reinnervation of the motor branches of the musculocutaneous nerve (three cases); and reinnervation using small grafts to the motor fascicles that enter the biceps muscle (five cases). Elbow flexion recovery ranged from M2 to M4+, according to the patient's age and the level of integrity of the hand. No surgery-related failure occurred. No significant difference in outcome was related to any of the technical variants. In patients younger than age 45 years and exhibiting a normal hand function a score of M4 or better was always achieved. On average, reinnervation occurred 6 months after surgery. There was no clinical evidence of donor nerve dysfunction. Conclusions When accurate selection criteria are met, the results after this type of neurotization have proved excellent.

The Use of Silicone Tubing In the Late Repair of the Median and Ulnar Nerves in the Forearm

1999 ◽  
Vol 24 (6) ◽  
pp. 703-706 ◽  
Author(s):  
J. BRAGA-SILVA
Keyword(s):  
Peripheral Nerve ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Silicone Tube ◽  
Silicone Tubing ◽  
The Mean ◽  
Injury And Repair ◽  
Tube Segment

A silicone tube segment was used for repairing the median and ulnar nerves in the forearm. This study includes 26 patients (20 male and six female), with a mean age of 23 years (range, 18-26). Injuries were caused by saw, knife and glass accidents, the latter being most frequent. The mean interval between the injury and repair was 101 days. Fourteen patients had median nerve injuries, eight had ulnar nerve injuries and four had both median and ulnar nerve injuries. The technique was effective in the repair of peripheral nerve injuries with gaps of up to 3 cm, with better results in the ulnar nerves than in the median nerves.

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