Anatomical study of vulnerable sensory and expendable motor nerves for targeted muscle reinnervation in the upper extremity

Purpose: Targeted muscle reinnervation (TMR) is a new technique for treating symptomatic neuroma, in which a sensory nerve after resection of a painful neuroma is coapted to an expendable motor nerve. There has been little information about optimal motor nerves for TMR of the vulnerable sensory ner...

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Main Authors: Kawamura Kenji, Hideo Hasegawa, Shohei Omokawa, Pasuk Mahakkanukrauh, Yasuhito Tanaka
Format: Article
Language:English
Published: Medical Journals Sweden 2025-02-01
Series:Journal of Plastic Surgery and Hand Surgery
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Online Access:https://medicaljournalssweden.se/JPHS/article/view/42655
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author Kawamura Kenji
Hideo Hasegawa
Shohei Omokawa
Pasuk Mahakkanukrauh
Yasuhito Tanaka
author_facet Kawamura Kenji
Hideo Hasegawa
Shohei Omokawa
Pasuk Mahakkanukrauh
Yasuhito Tanaka
author_sort Kawamura Kenji
collection DOAJ
description Purpose: Targeted muscle reinnervation (TMR) is a new technique for treating symptomatic neuroma, in which a sensory nerve after resection of a painful neuroma is coapted to an expendable motor nerve. There has been little information about optimal motor nerves for TMR of the vulnerable sensory nerves in the upper extremity. Methods: Fourteen upper extremities of fresh-frozen cadavers were dissected to describe the anatomical course of the vulnerable sensory nerves, which included the superficial radial nerve, the dorsal branch of the ulnar nerve, and the medial and lateral antebrachial cutaneous nerves. The bifurcation, diameter, and entry points in muscles of expendable motor nerves suitable for TMR of the sensory nerves were investigated. Results: The distal anterior interosseus nerve was available as a donor for TMR of the superficial radial nerve and the dorsal branch of the ulnar nerve in the distal third of the forearm. The motor branch to the pronator teres muscle was suitable for TMR of the medial antebrachial cutaneous nerve. It was possible to transfer the lateral antebrachial cutaneous nerve to the motor branch of the brachioradialis or extensor carpi radialis longus muscles. Conclusions: The results of this anatomical study provide useful information when TMR is applied for neuromas of the sensory nerves in the upper extremity.
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series Journal of Plastic Surgery and Hand Surgery
spelling doaj-art-dc0bc3a1b5af4189a3a1844b218550892025-08-25T11:16:02ZengMedical Journals SwedenJournal of Plastic Surgery and Hand Surgery2000-67642025-02-0160110.2340/jphs.v60.42655Anatomical study of vulnerable sensory and expendable motor nerves for targeted muscle reinnervation in the upper extremityKawamura Kenji0https://orcid.org/0000-0001-9743-7898Hideo Hasegawa1Shohei Omokawa2Pasuk Mahakkanukrauh3Yasuhito Tanaka4Department of Orthopaedic Surgery, Nara Medical University, Nara, JapanDepartment of Orthopaedic Surgery, Nara Medical University, Nara, JapanDepartment of Hand Surgery, Nara Medical University, Nara, JapanDepartment of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Orthopaedic Surgery, Nara Medical University, Nara, Japan Purpose: Targeted muscle reinnervation (TMR) is a new technique for treating symptomatic neuroma, in which a sensory nerve after resection of a painful neuroma is coapted to an expendable motor nerve. There has been little information about optimal motor nerves for TMR of the vulnerable sensory nerves in the upper extremity. Methods: Fourteen upper extremities of fresh-frozen cadavers were dissected to describe the anatomical course of the vulnerable sensory nerves, which included the superficial radial nerve, the dorsal branch of the ulnar nerve, and the medial and lateral antebrachial cutaneous nerves. The bifurcation, diameter, and entry points in muscles of expendable motor nerves suitable for TMR of the sensory nerves were investigated. Results: The distal anterior interosseus nerve was available as a donor for TMR of the superficial radial nerve and the dorsal branch of the ulnar nerve in the distal third of the forearm. The motor branch to the pronator teres muscle was suitable for TMR of the medial antebrachial cutaneous nerve. It was possible to transfer the lateral antebrachial cutaneous nerve to the motor branch of the brachioradialis or extensor carpi radialis longus muscles. Conclusions: The results of this anatomical study provide useful information when TMR is applied for neuromas of the sensory nerves in the upper extremity. https://medicaljournalssweden.se/JPHS/article/view/42655Neuromasensory nervetargeted muscle reinnervationupper extremity
spellingShingle Kawamura Kenji
Hideo Hasegawa
Shohei Omokawa
Pasuk Mahakkanukrauh
Yasuhito Tanaka
Anatomical study of vulnerable sensory and expendable motor nerves for targeted muscle reinnervation in the upper extremity
Journal of Plastic Surgery and Hand Surgery
Neuroma
sensory nerve
targeted muscle reinnervation
upper extremity
title Anatomical study of vulnerable sensory and expendable motor nerves for targeted muscle reinnervation in the upper extremity
title_full Anatomical study of vulnerable sensory and expendable motor nerves for targeted muscle reinnervation in the upper extremity
title_fullStr Anatomical study of vulnerable sensory and expendable motor nerves for targeted muscle reinnervation in the upper extremity
title_full_unstemmed Anatomical study of vulnerable sensory and expendable motor nerves for targeted muscle reinnervation in the upper extremity
title_short Anatomical study of vulnerable sensory and expendable motor nerves for targeted muscle reinnervation in the upper extremity
title_sort anatomical study of vulnerable sensory and expendable motor nerves for targeted muscle reinnervation in the upper extremity
topic Neuroma
sensory nerve
targeted muscle reinnervation
upper extremity
url https://medicaljournalssweden.se/JPHS/article/view/42655
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AT shoheiomokawa anatomicalstudyofvulnerablesensoryandexpendablemotornervesfortargetedmusclereinnervationintheupperextremity
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