Display options
Cite
Claro G, Zelenski NA, Balaguer T, et al. Flow-Through Arterialized Posterior Interosseous Nerve Grafts for Digital Neurovascular Bundle Defects: Anatomical Study. Plast Reconstr Surg. 2022;149(1):163-167doi: 10.1097/PRS.0000000000008629.
Claro, G., Zelenski, N. A., Balaguer, T., Chaput, B., Isola, N., Baqué, P., Bronsard, N., & Camuzard, O. (2022). Flow-Through Arterialized Posterior Interosseous Nerve Grafts for Digital Neurovascular Bundle Defects: Anatomical Study. Plastic and reconstructive surgery, 149(1), 163-167. https://doi.org/10.1097/PRS.0000000000008629
Claro, Gilles, et al. "Flow-Through Arterialized Posterior Interosseous Nerve Grafts for Digital Neurovascular Bundle Defects: Anatomical Study." Plastic and reconstructive surgery vol. 149,1 (2022): 163-167. doi: https://doi.org/10.1097/PRS.0000000000008629
Claro G, Zelenski NA, Balaguer T, Chaput B, Isola N, Baqué P, Bronsard N, Camuzard O. Flow-Through Arterialized Posterior Interosseous Nerve Grafts for Digital Neurovascular Bundle Defects: Anatomical Study. Plast Reconstr Surg. 2022 Jan 01;149(1):163-167. doi: 10.1097/PRS.0000000000008629. PMID: 34936617.
Copy Download .nbib Format: NLM
Share it on

Plast Reconstr Surg. 2022 Jan 01;149(1):163-167. doi: 10.1097/PRS.0000000000008629.

Flow-Through Arterialized Posterior Interosseous Nerve Grafts for Digital Neurovascular Bundle Defects: Anatomical Study.

Plastic and reconstructive surgery

Gilles Claro, Nicole A Zelenski, Thierry Balaguer, Benoit Chaput, Nicolas Isola, Patrick Baqué, Nicolas Bronsard, Olivier Camuzard

Affiliations

  1. From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Toulouse University Hospital, Hôpital Rangueil; Department of Orthopaedic Surgery, Mayo Clinic; Departments of Plastic and Reconstructive Surgery and Orthopaedic Surgery, Institut Universitaire Locomoteur et Sport, and Service de Chirurgie Viscérale d'Urgence, Hôpital Pasteur 2, University of Côte d'Azur; Department of Plastic, Reconstructive, and Aesthetic Surgery, Orléans Hospital; and Laboratoire d'Anatomie Normale, Faculté de Médecine de Nice, Université Côte d'Azur.

PMID: 34936617 DOI: 10.1097/PRS.0000000000008629

Abstract

BACKGROUND: Digital neurovascular bundle defects are often encountered during crush or avulsion injuries and require complex reconstruction. Use of an arterialized nerve graft (neurovascular graft) serving both as an interpositional arterial conduit and as a nerve graft could be a reconstructive option in these cases. In this anatomical study, the authors aimed to describe a neurovascular graft of the posterior interosseous nerve and a branch of the anterior interosseous artery for neurovascular bundle reconstruction of the fingers.

METHODS: Eighteen forearms were injected with red latex in order to collect the anatomical characteristics of the posterior interosseous nerve and the artery running near it.

RESULTS: In all cases, the posterior interosseous nerve was followed by a branch of the anterior interosseous artery: the distal dorsal branch of the anterior interosseous nerve. The origin of this artery was proximal to the radiocarpal joint, at an average of 56.5 ± 11.1 mm. The proximal and distal diameters of the branch of the anterior interosseous artery were 1.6 ± 0.2 and 1.1 ± 0.2 mm, respectively. The proximal and distal diameters of the posterior interosseous nerve were 1.2 ± 0.3 mm and 1.1 ± 0.3 mm, respectively.

CONCLUSIONS: These results show that a potential free neurovascular graft using the posterior interosseous nerve as nerve graft and the anterior interosseous artery as an arterial bypass to reconstruct both the nerve and arterial tree of the finger could be a useful approach. The authors speculate that this graft could be used to reconstruct the neurovascular bundle of amputated or devascularized digits.

Copyright © 2021 by the American Society of Plastic Surgeons.

References

  1. Ozaksar K, Toros T, Sügün TS, Kayalar M, Kaplan I, Ada S. Finger replantations after ring avulsion amputations. J Hand Surg Eur Vol. 2012;37:329–335. - PubMed
  2. Nyström A, Backman C. Replantation of the completely avulsed thumb using long arterial and venous grafts. J Hand Surg Br. 1991;16:389–391. - PubMed
  3. Arnez ZM, Lister GD. The posterior interosseous arterial graft. Plast Reconstr Surg. 1994;94:202–206. - PubMed
  4. Biemer E. Vein grafts in microvascular surgery. Ann Acad Med Singap. 1979;8:382–384. - PubMed
  5. Arnez ZM, Lister GD. The posterior interosseous arterial graft. Plast Reconstr Surg. 1994;94:202–206. - PubMed
  6. Godina M. Arterial autografts in microvascular surgery. Plast Reconstr Surg. 1986;78:293–294. - PubMed
  7. Foo A, Martin-Playa P, Sebastin Muttath SJ. Arterialized posterior interosseous nerve graft for digital neuroma. Tech Hand Up Extrem Surg. 2019;23:152–154. - PubMed
  8. Shibata M, Ogishyo N. Free flaps based on the anterior interosseous artery. Plast Reconstr Surg. 1996;97:746–755. - PubMed
  9. Bergeron L, Tang M, Morris SF. A review of vascular injection techniques for the study of perforator flaps. Plast Reconstr Surg. 2006;117:2050–2057. - PubMed
  10. Kakar S, Shin AY. Vascularized bone grafting from the dorsal distal radius for Kienböck’s disease: Technique, indications and review of the literature. Chir Main. 2010;29(Suppl 1):S104–S111. - PubMed
  11. Sheetz KK, Bishop AT, Berger RA. The arterial blood supply of the distal radius and ulna and its potential use in vascularized pedicled bone grafts. J Hand Surg Am. 1995;20:902–914. - PubMed
  12. Hu W, Martin D, Foucher G, Baudet J. [Anterior interosseous flap]. Ann Chir Plast Esthet. 1994;39:290–300. - PubMed
  13. Taylor GI, Ham FJ. The free vascularized nerve graft: A further experimental and clinical application of microvascular techniques. Plast Reconstr Surg. 1976;57:413–426. - PubMed
  14. Leslie BM, Ruby LK, Madell SJ, Wittenstein F. Digital artery diameters: An anatomic and clinical study. J Hand Surg Am. 1987;12(5 Pt 1):740–743. - PubMed
  15. Merle M, Dautel G. Vascularised nerve grafts. J Hand Surg Br. 1991;16:483–488. - PubMed
  16. Higgins JP, Fisher S, Serletti JM, Orlando GS. Assessment of nerve graft donor sites used for reconstruction of traumatic digital nerve defects. J Hand Surg Am. 2002;27:286–292. - PubMed
  17. Stang F, Stollwerck P, Prommersberger KJ, van Schoonhoven J. Posterior interosseus nerve vs. medial cutaneous nerve of the forearm: Differences in digital nerve reconstruction. Arch Orthop Trauma Surg. 2013;133:875–880. - PubMed
  18. Dellon AL. Partial dorsal wrist denervation: Resection of the distal posterior interosseous nerve. J Hand Surg Am. 1985;10:527–533. - PubMed
  19. Dellon AL, Seif SS. Anatomic dissections relating the posterior interosseous nerve to the carpus, and the etiology of dorsal wrist ganglion pain. J Hand Surg Am. 1978;3:326–332. - PubMed
  20. Hagert E, Persson JK. Desensitizing the posterior interosseous nerve alters wrist proprioceptive reflexes. J Hand Surg Am. 2010;35:1059–1066. - PubMed

Publication Types