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A-0338 Nerve transfer of motor branches from the Supinator muscle to the Posterior Interosseus Nerve in tetraplegia– a one-year follow up of 17 operated forearms.
Joakim Strömberg 1, Johanna Wangdell 1, Carina Reinholdt 1, Jan Fridén 1,2, 1 Centre for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Mölndal, Sweden; 2 Swiss Paraplegic Centre (SPZ), Nottwil, Switzerland
Friday, June 15, 2018 · 8:19 a.m. · 05m 53s
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thank you very much good morning everybody yeah thank you for the opportunity to present this
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novel treatment that we have introduced in our to tear
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previous surgery unit since two thousand four team
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so and uh your standard patient with the c. six injury intuitively it
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this is what you get from hand function you have wrist extension
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but no active section of the thing there and no active extension of the thinker
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well we used to do passive tended pieces to in order to provide an
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opening of the palm but now we do this instead of uh
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the whole concept was described by by telling in two thousand and ten and
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the principle is that the radio nerve contains mode or uh neurons
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from above the level of injury as well as the ones that come
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and a nice so if you look at the rate younger
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this tully it can things some fibres that are actually
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working and by using them we can provide extension
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so if you look at this you will see that the regular can things
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uh branches to superior which are in contact with the brain but the p. i. and there
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is totally the every inpatient with european seasick level
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so by typing in using these stupid nader branches and transferring them to the interest is
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never you can actually give extension to some patients so this is the principal uh
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so uh what i'm gonna tell you about is is seventeen the
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result of seventeen or transition but that within in eight patients
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and the we usually try to do them as quick as
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possible uh which means a totally new approach to the
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newly injured patient put utopia but but we in to
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do it the before twelve months after the injury
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uh and the this is is quite nice or do you actually is
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andrew and for lateral approach go through d. a. e. d. c.
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and you find your interest is no are you dissect the
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motor brushes and uh the blue vest loops shows they
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uh interest is near that has no a connection with the brain anymore and the red
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ones are the superior branches are still in contact so that they can conceive anything
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and we tried these yet or opportunity to see if that would be to have get is to punish an
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when you activate signal branches and also that you get extension of the fingers and a thumb or operative
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this is the uh scary part when you kept the function
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branches and transfer them to the interest isn't there
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visible looks like then we put the patient in a a a hinge earth those is for three weeks
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and then we take your clothes off so that these other assaults and for sending patients is
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the that eleven patients had detectable effect after one year of what you need is
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when you do you can then transferred you get the immediate results but you'd have to wait for innovation
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uh but in six arms we had a a good really
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innovation of motor control and finger and thumb extension
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and if i want you could detect that there was some stabilisation of the c. u. but take you really use it
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and and six i find no effect whatsoever so basically one third of the
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patients that we operated did yet acted extension of the thumb and fingers
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that can be of course be discussed so let's have a look at this patient the that show different as we can but she had
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yeah the veterinarian t. fallible course and this is eleven months post injury when we operated huh
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and this is what you look like a mouse haas talkative when
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she every innovative so she had regained extension of both
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some and the fingers you can also see that she's stupid waiting for
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sort of cheating but after a while they stop doing that
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and of course if you get new functions like extension of the thumb in the thing you you need to change your second there
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second as well so it for gripped reconstruction um we did rip reconstruction and this was what you
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look like when you're at work you can see that yes now interactive section as well
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uh which is mediated by any yeah but if your idea is to
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uh if you have p. l. transfer and v. c. r. l. to f. t. p. transfer
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uh sorry the action kind of yeah so the conclusion is that there is
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this is a novel option of for us that we offer the patient
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but of course you could discuss you have to tell the patients that the the uh for now the
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the ratio of successes one third but most patients except this because the want to get it
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yeah they are very very uh satisfied with that gender age is probably success
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factor we don't know that yet but pets that we think and uh
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we have to to approach our patience after the injury a lot earlier than we usually do
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we have done tendon transfers and reconstructions in the
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patient thirty eight years after after the injury
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what's a success for souls but still these are patients that we need to approach earlier
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yeah in order to to provide the best we innovation
Conference Program
A-0326 Single palmar approach for proximal row carpectomy and total wrist fusion in the spastic hand
Christoph Erling, Michael Hiller, Thomas Giesen, Olga Politikou, Maurizio Calcagni, University Hospital Zurich, Switzerland
June 15, 2018 · 8 a.m.
139 views
A-0515 Fractional lenghtening of the volar forearm muscles: anatomical study
Ahlam Arnaout, Caroline Leclercq, Institut de la Main, Paris, France
June 15, 2018 · 8:06 a.m.
380 views
A-0515 Fractional lenghtening of the volar forearm muscles: anatomical study - Q&A
June 15, 2018 · 8:12 a.m.
101 views
