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Reconstruction of a long defect of the median nerve with a free nerve conduit flap
Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Plastic and Reconstructive Surgeons
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093277/ https://www.ncbi.nlm.nih.gov/pubmed/32203996 http://dx.doi.org/10.5999/aps.2019.00654 |
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author | Campodonico, Andrea Pangrazi, Pier Paolo De Francesco, Francesco Riccio, Michele |
author_facet | Campodonico, Andrea Pangrazi, Pier Paolo De Francesco, Francesco Riccio, Michele |
author_sort | Campodonico, Andrea |
collection | PubMed |
description | Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the right forearm caused by broken glass, with soft tissue loss, complete transection of the radial and ulnar arteries, and a large median nerve gap. The patient underwent debridement and subsequent surgery with a microsurgical free radial fasciocutaneous flap to provide a direct blood supply to the hand; the cephalic vein within the flap was employed as a venous vascularized chamber to wrap the sural nerve graft and to repair the wide gap (14 cm) in the median nerve. During the postoperative period, the patient followed an intensive rehabilitation program and was monitored for functional performance over 5 years of follow-up. Our assessment demonstrated skin tropism and sufficient muscle power to act against strong resistance (M5) in the muscles previously affected by paralysis, as well as a good localization of stimuli in the median nerve region and an imperfect recovery of two-point discrimination (S3+). We propose a novel and efficient procedure to repair >10-cm peripheral nerve gap injuries related to upper limb trauma. |
format | Online Article Text |
id | pubmed-7093277 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Korean Society of Plastic and Reconstructive Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-70932772020-04-02 Reconstruction of a long defect of the median nerve with a free nerve conduit flap Campodonico, Andrea Pangrazi, Pier Paolo De Francesco, Francesco Riccio, Michele Arch Plast Surg Case Report Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the right forearm caused by broken glass, with soft tissue loss, complete transection of the radial and ulnar arteries, and a large median nerve gap. The patient underwent debridement and subsequent surgery with a microsurgical free radial fasciocutaneous flap to provide a direct blood supply to the hand; the cephalic vein within the flap was employed as a venous vascularized chamber to wrap the sural nerve graft and to repair the wide gap (14 cm) in the median nerve. During the postoperative period, the patient followed an intensive rehabilitation program and was monitored for functional performance over 5 years of follow-up. Our assessment demonstrated skin tropism and sufficient muscle power to act against strong resistance (M5) in the muscles previously affected by paralysis, as well as a good localization of stimuli in the median nerve region and an imperfect recovery of two-point discrimination (S3+). We propose a novel and efficient procedure to repair >10-cm peripheral nerve gap injuries related to upper limb trauma. Korean Society of Plastic and Reconstructive Surgeons 2020-03 2020-03-15 /pmc/articles/PMC7093277/ /pubmed/32203996 http://dx.doi.org/10.5999/aps.2019.00654 Text en Copyright © 2020 The Korean Society of Plastic and Reconstructive Surgeons This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Campodonico, Andrea Pangrazi, Pier Paolo De Francesco, Francesco Riccio, Michele Reconstruction of a long defect of the median nerve with a free nerve conduit flap |
title | Reconstruction of a long defect of the median nerve with a free nerve conduit flap |
title_full | Reconstruction of a long defect of the median nerve with a free nerve conduit flap |
title_fullStr | Reconstruction of a long defect of the median nerve with a free nerve conduit flap |
title_full_unstemmed | Reconstruction of a long defect of the median nerve with a free nerve conduit flap |
title_short | Reconstruction of a long defect of the median nerve with a free nerve conduit flap |
title_sort | reconstruction of a long defect of the median nerve with a free nerve conduit flap |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093277/ https://www.ncbi.nlm.nih.gov/pubmed/32203996 http://dx.doi.org/10.5999/aps.2019.00654 |
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