[Reconstruction of defects at the neuromuscular junction].
Loss of muscle tissue at the area of the neuromuscular junction after tumor resection or after trauma precludes the reconstruction with conventional nerve grafts, because the distal nerve stump is absent. For these cases, we recommend direct insertion of the nerve grafts into the muscle. We describe a standardized technique, which has been performed in 19 patients and led to a mean motor recovery of grade M4 after Highet. The key procedure of this technique is the interfascicular dissection of the nerve grafts, which allows a wide distribution of the grafts into the muscle tissue.
Lassner
F
F
Klinik für Plastische, Hand- und Verbrennungschirurgie, Rheinisch Westfälische Technische Hochschule Aachen. flassner@ukaachen.de
Becker
M
M
Fansa
H
H
Mawrin
C
C
Pallua
N
N
D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D019042:Muscle Neoplasms / Q000601:surgery; D018482:Muscle, Skeletal / Q000294:innervation*; D009416:Nerve Regeneration / Q000502:physiology; D016067:Nerve Transfer / Q000379:methods*; D009469:Neuromuscular Junction / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D020511:Neuromuscular Junction Diseases / Q000209:etiology / Q000601:surgery*; D010525:Peripheral Nerves / Q000637:transplantation*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery