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Hyperselective neurectomy in the treatment of elbow and wrist spasticity: an anatomical study and incision design
- Source :
- British Journal of Neurosurgery. :1-6
- Publication Year :
- 2020
- Publisher :
- Informa UK Limited, 2020.
-
Abstract
- Hyperselective neurectomy is used to treat spastic arm paralysis. The aim of the study was to analyze the nerve branching patterns of elbow and wrist flexors/pronator to inform hyperselective neurectomy approached.Eighteen upper extremities of fresh cadaver specimen were dissected. The number of motor branches from the musculocutaneous nerve to biceps brachii and brachialis, median nerve to pronator teres, flexor carpi radialis and ulnar nerve to flexor carpi ulnaris were counted. The origin site of each primary motor branch was documented.Either biceps or brachialis was innervated by one or two primary motor branches. Pronator teres was innervated by one to three motor trunks and the pattern for flexor carpi radialis was a common trunk with other branches. The origin of the biceps and brachialis nerve trunk was located approximately 30% to 60% of the length of the arm. The median nerve branched to pronator teres and flexor carpi radialis at the region about 34mm (SD 18.8mm) above and 50mm (SD 14.9mm) below the medial epicondyle. Flexor carpi ulnaris was innervated by one to three motor trunks and the mean distance from the medial epicondyle to the origin of flexor carpi ulnaris nerve on ulnar nerve was 18.7 mm (SD 6.5mm).Primary motor branches to elbow flexors, wrist flexors and pronators were various, while the regions of their origins were relatively settled. It was recommended the incisions be designed according to the location of the primary motor trunks.
- Subjects :
- musculoskeletal diseases
medicine.medical_specialty
business.industry
medicine.medical_treatment
Elbow
Neurectomy
General Medicine
Wrist
musculoskeletal system
body regions
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
Physical medicine and rehabilitation
030220 oncology & carcinogenesis
medicine
Spastic
Surgery
Arm paralysis
Neurology (clinical)
Spasticity
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 1360046X and 02688697
- Database :
- OpenAIRE
- Journal :
- British Journal of Neurosurgery
- Accession number :
- edsair.doi.dedup.....a19464309336bcde8beb8d77b633ab79