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Tissue-engineered rhesus monkey nerve grafts for the repair of long ulnar nerve defects:similar outcomes to autologous nerve grafts

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Neural Regeneration Research 2016年第11期11卷 1845-1850页

作者： Chang-qing Jiang Jun Hu Jian-ping Xiang Jia-kai Zhu Xiao-lin Liu Peng Luo Department of Sports Medicine and Rehabilitation Peking Universtiy Shenzhen Hospital Shenzhen Guangdong Province China Department of Microscopy First Affiliated Hospital of Sun Yat-sen University Guangzhou Guangdong Province China The Sixth People's Hospital of Shenzhen City Shenzhen Guangdong Province China

Acellular nerve allografts can help preserve normal nerve structure and extracellular matrix composition. These allografts have low immunogenicity and are more readily available than autologous nerves for the repair of long-segment peripheral nerve defects. In this study, we repaired a 40-mm ulnar nerve defect in rhesus monkeys with tissue-engineered peripheral nerve, and compared the outcome with that of autograft. The graft was prepared using a chemical extract from adult rhesus monkeys and seeded with allogeneic Schwann cells. Pathomo- rphology, electromyogram and immunohistochemistry findings revealed the absence of palmar erosion or ulcers, and that the morphology and elasticity of the hypothenar eminence were normal 5 months postoperatively. There were no significant differences in the mean peak compound muscle action potential, the mean nerve conduction velocity, or the number of neurofilaments between the experimental and control groups. However, outcome was significantly better in the experimental group than in the blank group. These findings suggest that chemically extracted allogeneic nerve seeded with autologous Schwann cells can repair 40-mm ulnar nerve defects in the rhesus monkey. The outcomes are similar to those obtained with autologous nerve graft.

关键词： nerve regeneration peripheral nerve injury tissue engineering rhesus monkey ulnar nerve chemical extraction allogenic nerve autologous nerve transplantation Schwann cells neural regeneration

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Anterior Subcutaneous Transposition of the ulnar nerve Affects Elbow Range of Motion： A Mean 13.5 Years of Follow-up

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Chinese Medical Journal 2018年第3期131卷 282-288页

作者： Xing-Hua Liu Mao-Qi Gong Yang Wang Chang Liu Shao-Liang Li Xie-Yuan Jiang Department of Orthopedic Trauma Beijing Jishuitan Hospital Beijing 100035 China Department of Hand Surgery Beijing Jishuitan Hospital Beijing 100035 China

Background：Surgical decompression of the ulnar nerve is effective for cubital tunnel ***,deep approaches may result in iatrogenic elbow *** long-term study was to evaluate the range of motion （ROM） of the elbow and functional outcomes after anterior subcutaneous ***：A total of 115 patients （78 male and 37 female;mean age：46.6 years） who underwent anterior subcutaneous transposition of the ulnar nerve between 2001 and 2005 were evaluated retrospectively;mean follow-up was 13.5 *** ROM was measured as flexion arc,flexion,and extension preoperatively and at the final follow-up,and compared via a mixed analysis of variance adjusting for *** was assessed preoperatively using a modified McGowan neuropathy grade and postoperatively using modified Wilson-Krout *** ordinal logistic regression analysis used postoperative modified Wilson-Krout criteria as the outcome and preoperative factors as ***：Preoperative McGowan grades were Grade 1 in 14 patients （12.2%）,Grade 2A in 28 （24.3%）,Grade 2B in 53 （46.1%）,and Grade 3 in 20 （17.4%） ***,66 patients （57.4%） had excellent results,26 （22.6%） had good results,16 （13.9%） had fair results,and 7 （6.1%） had poor results at the final follow-up,as per the Wilson-Krout *** were no ***-and postoperative elbow ROM was significantly decreased in patients with previous trauma or surgery of the elbow compared with those without （P 〈 0.05）.Anterior subcutaneous transposition of the ulnar nerve did not significantly affect elbow ROM regardless of previous trauma or surgical history nor preoperative ROM （P 〉 0.05）,after adjusting for *** with prolonged symptoms prior to surgery and worse neuropathy tended to have less satisfactory functional outcomes （P 〈 0.05）,after adjusting for ***：Anterior subcutaneous transposition of the ulnar nerve is an effective and reliable treatment of cubital tun

关键词： Cubital Tunnel Syndrome Elbow Stiffness Neuropathy Transposition ulnar nerve

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Sleeve bridging of the rhesus monkey ulnar nerve with muscular branches of the pronator teres: multiple amplification of axonal regeneration

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Neural Regeneration Research 2015年第1期10卷 53-59页

作者： Yu-hui Kou Pei-xun Zhang Yan-hua Wang Bo Chen Na Han Feng Xue Hong-bo Zhang Xiao-feng Yin Bao-guo Jiang Department of Trauma and Orthopedics Peking University People’s Hospital

Multiple-bud regeneration, i.e., multiple amplification, has been shown to exist in peripheral nerve regeneration. Multiple buds grow towards the distal nerve stump during proximal nerve fiber regeneration. Our previous studies have verified the limit and validity of multiple ampli- fication of peripheral nerve regeneration using small gap sleeve bridging of small donor nerves to repair large receptor nerves in rodents. The present study sought to observe multiple ampli- fication of myelinated nerve fiber regeneration in the primate peripheral nerve. Rhesus monkey models of distal ulnar nerve defects were established and repaired using muscular branches of the right forearm pronator teres. Proximal muscular branches of the pronator teres were su- tured into the distal ulnar nerve using the small gap sleeve bridging method. At 6 months after suture, two-finger flexion and mild wrist flexion were restored in the ulnar-sided injured limbs of rhesus monkey. Neurophysiological examination showed that motor nerve conduction veloc- ity reached 22.63 _＋ 6.34 m/s on the affected side of rhesus monkey. Osmium tetroxide staining demonstrated that the number of myelinated nerve fibers was 1,657 ＋ 652 in the branches of pronator teres of donor, and 2,661 ~ 843 in the repaired ulnar nerve. The rate of multiple amplification of regenerating myelinated nerve fibers was 1.61. These data showed that when muscular branches of the pronator teres were used to repair ulnar nerve in primates, effective regeneration was observed in regenerating nerve fibers, and functions of the injured ulnar nerve were restored to a certain extent. Moreover, multiple amplification was subsequently detected in ulnar nerve axons.

关键词： nerve regeneration peripheral nerve rhesus monkey muscular branches of pronator teres ulnar nerve multiple amplification small gap sleeve bridging NSFC grants neural regeneration

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Applied anatomical study of the vascularized ulnar nerve and its blood supply for cubital tunnel syndrome at the elbow region

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Neural Regeneration Research 2015年第1期10卷 141-145页

作者： Mei-xiu-li Li Qiong He Zhong-lin Hu Sheng-hua Chen Yun-cheng Lv Zheng-hai Liu Yong Wen Tian-hong Peng Laboratory of Clinical Anatomy University of South China Department of Radiology Chen-xi Hospital

Cubital tunnel syndrome is often accompanied by paresthesia in ulnar nerve sites and hand muscle atrophy. When muscle weakness occurs, or after failure of more conservative treatments, anterior transposition is used. In the present study, the ulnar nerve and its blood vessels were examined in the elbows of 18 adult cadavers, and the external diameter of the nutrient vessels of the ulnar nerve at the point of origin, the distances between the origin of the vessels and the medial epicondyle of the humerus, and the length of the vessels accompanying the ulnar nerve in the superior ulnar collateral artery, the inferior ulnar collateral artery, and the posterior ulnar recurrent artery were measured. Anterior transposition of the vascularized ulnar nerve was per- formed to treat cubital tunnel syndrome. The most appropriate distance that the vascularized ulnar nerve can be moved to the subcutaneous tissue under tension-free conditions was 1.8 ± 0.6 cm （1.1-2.5 cm）, which can be used as a reference value during the treatment of cubital tunnel syndrome with anterior transposition of the vascularized ulnar nerve.

关键词： nerve regeneration ulnar nerve blood supply compressive neuropathy cubital tunnelsyndrome superior ulnar collateral artery inferior ulnar collateral artery posterior ulnar recurrentartery anterior transposition neural regeneration

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Axonal degeneration of the ulnar nerve secondary to carpal tunnel syndrome: fact or fiction?

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Neural Regeneration Research 2013年第15期8卷 1418-1422页

作者： Radwa Mahmoud Azmy Amira Ahmed Labib Saly Hassan Elkholy Department of Special Medicine Faculty of Medicine Cairo University

The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment is still unclear. In this study, we measured ulnar nerve function in 82 patients with carpal tunnel syndrome. The patients were divided into group I with minimal carpal tunnel syndrome （n = 35） and group II with mild to moderate carpal tunnel syndrome （n = 47） according to electrophysiological data. Sixty-one age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. There were no significant differences in ulnar sensory nerve peak latencies or conduction velocities from the 4th and 5th fingers between patients with carpal tunnel syndrome and the control group. The ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were lower in patients with carpal tunnel syndrome than in the control group. The ratios of the ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were almost the same in patients with carpal tunnel syndrome as in the control group. These findings indicate that in patients with minimal to moderate carpal tunnel syndrome, there is some electrophysiological evidence of traction on the adjacent ulnar nerve fibers. The findings do not indicate axonal degeneration of the ulnar nerve.

关键词： neural regeneration peripheral nerve injury carpal tunnel syndrome median nerve extra-mediansymptoms motor conduction sensory conduction ulnar nerve ulnar amplitude ratio neuroregeneration

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Missed ulnar nerve injury and closed forearm fracture in a child

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Chinese Journal of Traumatology 2013年第4期16卷 246-248页

作者： Batra Amit Devgan Ashish Verma Vinit Singh Raj Batra Shivan Magu Narender Singla Rohit Gogna ParitoshGupta Navdeep Department of Orthopedics PGIMS Rohtak HaryanaIndia

ulnar nerve injury in closed fracture of lbrearnl in children is uncommon. Commonly, neurapraxia is the reason for this palsy but other severe injuries or nerve entrapment has been reported in some cases. The impor- tance of diagnosis concerning the types of the nerve injury lies in the fact that they have totally different management. We present a case of ulnar nerve deficit in a child following a closed fracture of the forearm bones. It is imperative to diagnose exact cause of palsy as it forms the basis for treatment. MR1 scan can help diagnosis and accordingly guide the management. Simple nelwe contusion should be treated conservatively, and exploration with fixation of the fracture should be done in lacerations and entrapments of the nerve. Surgery is not the treatment of choice in cases that could be managed conserwltively.

关键词： ulnar nerve Peripheral nerve injuries Forearm injuries Child

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Three-dimensional visualization of the functional fascicular groups of a long-segment peripheral nerve

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Neural Regeneration Research 2018年第8期13卷 1465-1470页

作者： Jian Qi Wei-Ya Wang Ying-Chun Zhong Jia-Ming Zhou Peng Luo Ping Tang Cai-Feng He Shuang Zhu Xiao-Lin Liu Yi Zhang Department of Orthopedics and Microsurgery First Affiliated Hospital of Sun Yat-sen University Department of Plastic Surgery Nanxishan Hospital of Guangxi Zhuang Autonomous Region Automation College Guangdong University of Technology Scientific Research Department Sixth Affiliated Hospital of Sun Yat-sen University Department of Orthopedics Shenzhen Nanshan People's Hospital Zhongshan University Medical Equipment Co. Ltd. Department of Joint and Orthopedics Orthopedic Center Zhujiang Hospital of Southern Medical University Department of Plastic Surgery First Affiliated Hospital of Sun Yat-sen University

The three-dimensional（3D） visualization of the functional bundles in the peripheral nerve provides direct and detailed intraneural spatial information. It is useful for selecting suitable surgical methods to repair nerve defects and in optimizing the construction of tissue-engineered nerve grafts. However, there remain major technical hurdles in obtaining, registering and interpreting 2D images, as well as in establishing 3D models. Moreover, the 3D models are plagued by poor accuracy and lack of detail and cannot completely reflect the stereoscopic microstructure inside the nerve. To explore and help resolve these key technical problems of 3D reconstruction, in the present study, we designed a novel method based on re-imaging techniques and computer image layer processing technology. A 20-cm ulnar nerve segment from the upper arm of a fresh adult cadaver was used for acetylcholinesterase（ACh E） staining. Then, 2D panoramic images were obtained before and after ACh E staining under the stereomicroscope. Using layer processing techniques in Photoshop, a space transformation method was used to fulfill automatic registration. The contours were outlined, and the 3D rendering of functional fascicular groups in the long-segment ulnar nerve was performed with Amira 4.1 software. The re-imaging technique based on layer processing in Photoshop produced an image that was detailed and accurate. The merging of images was accurate, and the whole procedure was simple and fast. The least square support vector machine was accurate, with an error rate of only 8.25%. The 3D reconstruction directly revealed changes in the fusion of different nerve functional fascicular groups. In conclusion. The technique is fast with satisfactory visual reconstruction.

关键词： nerve regeneration peripheral nerve ulnar nerve three-dimensional reconstruction functional fascicular group registration segmentation locating spots auto-registration acetylcholinesterase neural regeneration

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Is it necessary to use the entire root as a donor when transferring contralateral C7 nerve to repair median nerve？

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Neural Regeneration Research 2018年第1期13卷 94-99页

作者： Kai-ming Gao Jie Lao Wen-jie Guan Jing-jing Hu Department of Hand Surgery Huashan Hospital Fudan University Shanghai China Key Laboratory of Hand Reconstruction Ministry of Health Shanghai China Shanghai Key Laboratory of Peripheral nerve and Microsurgery Shanghai China Nursing Department Huashan Hospital Fudan University Shanghai China

If a partial contralateral C7 nerve is transferred to a recipient injured nerve, results are not satisfactory. However, if an entire contralateral C7 nerve is used to repair two nerves, both recipient nerves show good recovery. These findings seem contradictory, as the above two methods use the same donor nerve, only the cutting method of the contralateral C7 nerve is different. To verify whether this can actually result in different repair effects, we divided rats with right total brachial plexus injury into three groups. In the entire root group, the entire contralateral C7 root was transected and transferred to the median nerve of the affected limb. In the posterior division group, only the posterior division of the contralateral C7 root was transected and transferred to the median nerve. In the entire root ＋ posterior division group, the entire contralateral C7 root was transected but only the posterior division was transferred to the median nerve. After neurectomy,the median nerve was repaired on the affected side in the three groups. At 8, 12, and 16 weeks postoperatively, electrophysiological examination showed that maximum amplitude, latency, muscle tetanic contraction force, and muscle fiber cross-sectional area of the flexor digitorum superficialis muscle were significantly better in the entire root and entire root ＋ posterior division groups than in the posterior division group. No significant difference was found between the entire root and entire root ＋ posterior division groups. Counts of myelinated axons in the median nerve were greater in the entire root group than in the entire root ＋ posterior division group, which were greater than the posterior division group. We conclude that for the same recipient nerve, harvesting of the entire contralateral C7 root achieved significantly better recovery than partial harvesting, even if only part of the entire root was used for transfer. This result indicates that the entire root should be used as a dono

关键词： nerve regeneration peripheral nerve injury brachial plexus injury avulsion injury contralateral C7 transfer nerve root entire root partial root median nerve ulnar nerve animal experiment neural regeneration

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Bilateral snapping triceps syndrome:A case report

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World Journal of Clinical Cases 2023年第34期11卷 8228-8234页

作者： Chul-Hyun Cho Kyung-Hwan Lim Du-Han Kim Department of Orthopedic Surgery Keimyung University Dongsan HospitalKeimyung University School of MedicineDaegu 42601South Korea Orthopedic Surgery Allright HospitalDaegu 42038South Korea

BACKGROUND Snapping triceps syndrome(STS)is a rare disease,while occurrence of bilateral STS is extremely *** is usually accompanied by dislocation of the ulnar nerve and double snapping is a clinically important ***,to the best of our knowledge,there has been no report of bilateral STS in young active *** SUMMARY A 23-year-old male presented with a complaint of discomfort and snapping on the medial side of both elbows while performing *** physical examination,two distinct snaps that were both palpable and audible were detected on additional clinical *** ultrasonography showed that the ulnar nerve and the medial head of the triceps were dislocated anteriorly over the medial epicondyle of the elbow during flexion ***,he was diagnosed as dislocation of the ulnar nerve and *** anterior subcutaneous transposition of the ulnar nerve combined with partial resection of the snapping portion of the triceps was *** patient’s pain and snapping symptoms were resolved immediately after *** months later,the patient was completely asymptomatic and returned to normal *** STS should be included in the differential diagnosis for active young patients who present with painful snapping on the medial side of the elbow joint,particularly when dislocation of the ulnar nerve is *** sonography is used to assist in accurate diagnosis and differentiation between isolated dislocation of the ulnar nerve and STS.

关键词： Triceps Triceps snapping syndrome ulnar nerve Elbow Dynamic sonography Case report

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A SURVEY ON ACUPUNCTURE TREATMENT OF PERIPHERAL nerve INJURY

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Journal of Traditional Chinese Medicine 1999年第3期19卷 221-226页

作者：邵永金单宝枝 Shanghai University of Traditional Chinese Medicine Shanghai 200032

By peripheral nerve injury, we mean theloss of neurosensory and neuromotor functionsinduced by various causative factors,manifesting paralysis of the limbs andmuscular atrophy. It falls into the category ofinjury of t... 详细信息

关键词： Acupuncture Therapy Brachial Plexus Humans Radial nerve ulnar nerve Wounds and Injuries

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