Microneurosurgical planning in toe-to-hand transplantation: axonal population of digital nerves in the fingers and toes. 2012

Fu-Chan Wei, and Yu-Yi Chien, and Hae-Shya Ma, and A Lee Dellon
Department of Plastic Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan.

Although toe-to-hand microvascular transplantation is now an accepted and successful reconstructive strategy for the thumb, there remains varying success in recovery of sensibility. The purpose of the present study was to provide an anatomic basis for analyzing neurotization of the great toe or the second toe with the digital nerves of the fingers and hand. Axon counts were obtained from donor and recipient nerves during reconstructive procedures. Sixty-seven upper- and eighty lower-extremity nerves were analyzed. No statistical difference was found between the mean number of axons between the thumb and the index finger; however, the thumb had significantly more (p < 0.001) axons than the middle or the ring finger. The great toe had significantly more axons than the second toe (p < 0.001). The common plantar digital nerve had significantly more axons than a digital nerve (p < 0.001). The thumb had significantly more axons than the great toe (p < 0.001). The thumb had significantly more axons than the second toe (p < 0.001). Numerical data are now available for strategic planning of toe transplantation, and direct neurotization from the dorsum of the hand to the digits.

UI MeSH Term Description Entries
D008866 Microsurgery The performance of surgical procedures with the aid of a microscope.
D010525 Peripheral Nerves The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. Endoneurium,Epineurium,Perineurium,Endoneuriums,Epineuriums,Nerve, Peripheral,Nerves, Peripheral,Perineuriums,Peripheral Nerve
D005385 Fingers Four or five slender jointed digits in humans and primates, attached to each HAND. Finger
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001369 Axons Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. Axon
D014034 Toes Any one of five terminal digits of the vertebrate FOOT. Toe
D019635 Neurosurgical Procedures Surgery performed on the nervous system or its parts. Procedures, Neurosurgical,Surgical Procedures, Neurologic,Neurologic Surgical Procedure,Neurologic Surgical Procedures,Neurosurgical Procedure,Procedure, Neurologic Surgical,Procedure, Neurosurgical,Procedures, Neurologic Surgical,Surgical Procedure, Neurologic

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