Músculos anómalos del antebrazo y su relevancia clínica.

Anomalous Forearm Muscles and Their Clinical Relevance.

 

Fuente

Este artículo es publicado originalmente en:

https://www.ncbi.nlm.nih.gov/pubmed/29602650

https://www.jhandsurg.org/article/S0363-5023(17)30571-3/fulltext

 

De:

Andring N1Kennedy SA1Iannuzzi NP2.

 2018 May;43(5):455-463. doi: 10.1016/j.jhsa.2018.02.028. Epub 2018 Mar 27.

 

Todos los derechos reservados para:

© 2018 by the American Society for Surgery of the Hand. All rights reserved.

 

Abstract

Despite their relatively low prevalence in the population, anomalous muscles of the forearm may be encountered by nearly all hand and wrist surgeons over the course of their careers. We discuss 6 of the more common anomalous muscles encountered by hand surgeons: the aberrant palmaris longus, anconeus epitrochlearis, palmaris profundus, flexor carpi radialis brevis, accessory head of the flexor pollicis longus, and the anomalous radial wrist extensors. We describe the epidemiology, anatomy, presentation, diagnosis, and treatment of patients presenting with an anomalous muscle. Each muscle often has multiple variations or subtypes. The presence of most anomalous muscles is difficult to diagnose based on patient history and examination alone, given that symptoms may overlap with more common pathologies. Definitive diagnosis typically requires soft tissue imaging or surgical exploration. When an anomalous muscle is present and symptomatic, it often requires surgical excision for symptom resolution.

KEYWORDS:

Anatomy; forearm; hand; muscle; variant

 

 

 

Resumen

 

A pesar de su prevalencia relativamente baja en la población, casi todos los cirujanos de manos y muñecas pueden encontrar músculos anómalos del antebrazo en el transcurso de sus carreras. Discutimos 6 de los músculos anómalos más comunes encontrados por cirujanos de mano: el aberrante palmar largo, anconeus epitroclear, palmar profundo, flexor radial corto del carpo, cabeza accesoria del flexor largo del pulgar, y los extensores anómalos de la muñeca radial. Describimos la epidemiología, la anatomía, la presentación, el diagnóstico y el tratamiento de pacientes que presentan un músculo anómalo. Cada músculo a menudo tiene múltiples variaciones o subtipos. La presencia de la mayoría de los músculos anómalos es difícil de diagnosticar según la historia del paciente y el examen solo, dado que los síntomas pueden solaparse con las patologías más comunes. El diagnóstico definitivo generalmente requiere imágenes de tejidos blandos o exploración quirúrgica. Cuando un músculo anómalo está presente y es sintomático, a menudo requiere una escisión quirúrgica para la resolución de los síntomas.

 

PALABRAS CLAVE:

Anatomía; antebrazo; mano; músculo; variante

 

PMID: 29602650  DOI:  10.1016/j.jhsa.2018.02.028

 

 

Etiología de atrapamiento: Neuropatía del nervio cubital en el antebrazo

Etiology of Entrapment: Neuropathy of the Ulnar Nerve in the Forearm

 

Fuente

Este artículo y/o video es originalmente publicado en:

https://youtu.be/xzj2gYx3Cmg

 

De y Todos los derechos reservados para:

 

Courtesy: Seattle Science Foundation, www.seattlesciencefoundation.org

 

Brachialis to Anterior Interosseous Nerve Transfer with Extended Forearm Incision – Standard

Fuente
Este artículo es originalmente publicado en:

 

https://youtu.be/bPzOwtA8Hww

 

 

De y Todos los derechos reservados para:

 

Courtesy : Authors: Susan E. Mackinnon, Andrew Yee Affiliation: Washington University School of Medicine Division of Plastic Reconstructive Surgery Department of Surgery Saint Louis, MO Peripheral Nerve Surgery: http://nervesurgery.wustl.edu
Brachialis to Anterior Interosseous Nerve Transfer with Extended Forearm Incision
Standard Edition (140312.140314)

 

 

Loss of flexor pollicis longus and radial profundus function results in a deficit of pinch and reduced grip strength in the hand. This palsy can be isolated or commonly included in a lower brachial plexus injury. The brachialis nerve is an available, synergistic, and powerful donor for transfer in these scenarios, especially in C7,8,T1 injuries and when other common donors are unavailable due to injury like the extensor carpi radialis brevis. In this case, the patient presented three months following a partial C7 and C8,T1 brachial plexus injury from a fall with no recovery on electrodiagnostic studies. The brachialis to anterior interosseous nerve transfer was elected with the supinator to flexor digitorum superficialis nerve transfer and lateral antebrachial cutaneous to ulnar sensory nerve transfer. This video details the specifics for the brachialis transfer with an extended incision into the forearm to confirm the proximal topography of the anterior interosseous fascicle in the median nerve. Additionally, this patient has an anomalous sensory nerve anastomosis from a brachialis nerve branch to the sensory component of the median nerve.

Tables of Contents (Standard)
00:57 Proximal Arm Exposure
01:51 Exposure and Identification of Median Nerve in the Arm
03:18 Exposure and Identification of Musculocutaneous Nerve and Brachialis Branch
04:41 Neurolysis of Median Nerve to Identify the Pronator Teres and AIN Fascicles
07:38 Distal Forearm Exposure
08:34 Step-lengthening the Pronator Teres for Proximal Median Nerve Exposure
10:36 Exposure of Median Nerve in the Forearm
11:05 Identifying the Distal Pronator Teres Branch
12:20 Identifying the Proximal Pronator Teres Branch and Proximal Neurolysis
12:52 Exposure of Anterior Interosseous Nerve Branch
14:16 Extension of Proximal Arm Exposure
14:58 Fascicular Course of the Anterior Interosseous Nerve from Distal to Proximal
16:42 Dissection and Distal Division of Donor Brachialis Nerve Branch
17:27 Anomalous Sensory Anastomosis from Brachialis Nerve Branch to Median Nerve
18:25 Neurolysis and Proximal Division of Recipient Anterior Interosseous Fascicle
19:42 Brachialis to Anterior Interosseous Nerve Transfer

Narration: Susan E. Mackinnon
Videography: Andrew Yee