Anatomical Feasibility Study of Superficial Branch of Radial Sensory Nerve Transfer to Sensory Branch of Ulnar Nerve in Lower Arm Type of Brachial Plexus Injury
Keywords:Superficial branch of radial sensory nerve, Sensory branch of ulnar nerve, Brachial plexus injury, Neurotization or nerve transfer
Background : Patients who were diagnosed with C7-T1 brachial plexus injury lost sensation in the area which was supplied by the sensory branch of the ulnar nerve. Neurotization or nerve transfer of the radial branch of the superficial radial nerve (RSRN) to the sensory branch of the ulnar nerve would provide the protective sensation method in these group of patients.
Objectives : To study the feasibility in transferring the RSRN to the sensory branch of the ulnar nerve by studying the relationship between the arm length, nerves and branches of the superficial radial nerve (SBRN), in both male and female.
Methods : To study 80 cadaver´s forearms, measuring arm length, the RSRN and the sensory branch of the ulnar nerve. Studying the number of SBRN branches and a suitable surgery procedure of nerve transfer surgery for both male and female by defining a clear reference point. The measurements were measured by the physician with intra-observer reliability test ICC>0.9.
Results : The arm length was significantly related to the sensory branch of the ulnar nerve (p = 0.001) but there was no significant change relating to the radial nerve (RSRN) (p = 0.439). The SBRN from both male and female had two branches and were suitable for the surgical procedure.
Conclusions : Nerve transfer of the radial branch of the superficial radial nerve (RSRN) to the sensory branch of the ulnar nerve was feasible, with no tension at the suture point. We found every cadaver had two branches of the superficial radial nerve (SBRN), with possible minor donor site deficit because it was compensated by the ulnar branch of the superficial radial nerve and median nerve.
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