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An alternative method for restoring opposition after median nerve injury: an anatomical feasibility study for the use of neurotisation

Published online by Cambridge University Press:  07 June 2001

MEHMET ERKAN ÜSTÜN
Affiliation:
Department of Neurosurgery, Selçuk University Medical Faculty, Konya, Turkey
TUNÇ CEVAT ÖĞÜN
Affiliation:
Departments of Orthopaedics and Traumatology, Selçuk University Medical Faculty, Konya, Turkey
A. KAĞAN KARABULUT
Affiliation:
Department of Anatomy, Selçuk University Medical Faculty, Konya, Turkey
MUSTAFA BÜYÜKMUMCU
Affiliation:
Department of Anatomy, Selçuk University Medical Faculty, Konya, Turkey
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Abstract

Opposition, one of the most important functions of the hand, is lost or impaired after median nerve injury. Complete recovery does not always occur after treatment, and various techniques of opponensplasty are used for restoring opposition. This study was performed in order to develop an alternative method for selective restoration of thenar muscle function. Ten arms from 5 cadavers were used. The median nerve with its thenar motor branch (Tb) and the anterior interosseous nerve with its motor branch to pronator quadratus (PQb) were prepared in the distal forearm. The mean widths and the number of myelinated fibres of these nerves were: PQb 1.3±0.10 mm, Tb 1.4±0.12 mm and PQb 912±88 mm, Tb 1020±93 mm. The minimum necessary distance from the distal flexor crease of the wrist for neurotisation of the Tb by the PQb was 60±5.41 mm. It was concluded that PQb-Tb neurotisation would be possible anatomically. The advantages are that motor function is reestablished with a motor nerve, the diameters and the number of myelinated fibres of both nerves are similar, the loss of function after denervation of the pronator quadratus is slight and opponensplasty still remains as a final option.

Type
Short Report
Copyright
© Anatomical Society of Great Britain and Ireland 2001

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