Journal of reconstructive microsurgery
-
J Reconstr Microsurg · Mar 2015
Ulnar nerve transposition at the elbow under local anesthesia: a patient satisfaction study.
Ulnar nerve decompression at the elbow traditionally requires regional or general anesthesia. We wished to assess the feasibility of performing ulnar nerve decompression and transposition at the elbow under local anesthesia. ⋯ Ulnar nerve decompression and transposition at the elbow can be performed under local anesthesia without added morbidity when compared with general anesthesia.
-
J Reconstr Microsurg · Feb 2015
Clinical outcome following transfer of the supinator motor branch to the posterior interosseous nerve in patients with C7-T1 brachial plexus palsy.
In cases of C7-T1 brachial plexus palsy, a reliable method for the reconstruction of the finger and thumb extension was not established until the transfer of the supinator motor branch to the posterior interosseous nerve was proposed. The long-term outcome of this new technique requires evaluation due to the limited number of cases and the shorter follow-up period of the previous study. ⋯ The supinator motor branch transfer is a safe procedure that yields recovery of finger extension in C7-T1 brachial plexus palsies with encouraging long-term outcomes.
-
J Reconstr Microsurg · Feb 2015
Rectal pain of neural origin: resection of sensory rectal branches of pudendal nerve.
A neural origin should be considered in the differential diagnosis of rectal pain if the onset of the pain is in relationship to previous surgery on the anus or rectum. ⋯ Chronic rectal pain should be considered to have a pudendal neural origin after previous anal/rectal surgery. Resection of all rectal sensory branches can give excellent and lasting relief of pain.
-
J Reconstr Microsurg · Jan 2015
ReviewFunctional abdominal wall reconstruction using an innervated abdominal wall vascularized composite tissue allograft: a cadaveric study and review of the literature.
Large, composite abdominal wall defects represent complex problems requiring a multidisciplinary approach for reconstruction. Abdominal wall vascularized composite allotransplantation (AW-VCA) has been successfully performed in 21 patients, already receiving solid organ transplants, to provide immediate abdominal closure. The current study aims to establish a novel anatomic model for AW-VCA that retains motor and sensory function in an effort to preserve form and function while preventing complications. ⋯ Motor function and sensory recovery is expected in other forms of vascularized composite allotransplantation, such as the hand or face; however, this has never been tested in AW-VCA. This study demonstrates feasibility for the transplantation of large, composite abdominal wall constructs that potentially retains movement, strength, and sensation through neurotization of both sensory and motor nerves.
-
J Reconstr Microsurg · Jan 2015
Diagnostic accuracy of three sensory tests for diagnosis of sensory disturbances.
Clinical diagnosis of sensory disturbances is extremely challenging, partly because the utility of sensory tests is questionable. Transection of C7 nerve root provides an objective assessment model to determine the diagnostic accuracy of sensory tests. The purpose of this study was to investigate the diagnostic accuracy of Semmes-Weinstein Monofilaments (SWM; Sammons Preston, Bolingbrook, IL), static two-point discrimination (s2PD), and current perception threshold (CPT) tests in patients with contralateral C7 nerve root transfer. ⋯ The SWM and CPT tests show a small capacity to detect sensory disturbances, whereas the s2PD test does not show any diagnostic capacity. To better understand sensory disturbances, a comprehensive testing protocol including valid measures of physical impairment and symptom-specific measurement tools should be adopted.