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Planitzer, U; Steinke, H; Meixensberger, J; Bechmann, I; Hammer, N; Winkler, D.
Median nerve fascicular anatomy as a basis for distal neural prostheses.
Ann Anat. 2014; 196(2-3):144-149 Doi: 10.1016/j.aanat.2013.11.002
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Co-authors Med Uni Graz

Hammer Niels

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Abstract:

Functional electrical stimulation (FES) serves as a possible therapy to restore missing motor functions of peripheral nerves by means of cuff electrodes. FES is established for improving lower limb function. Transferring this method to the upper extremity is complex, due to a lack of anatomical data on the physiological configuration of nerve fascicles. Our study's aim was to provide an anatomical basis for FES of the median nerve in the distal forearm and hand. We investigated 21 distal median nerves from 12 body donors. The peripheral fascicles were traced back by removing the external and interfascicular epineurium and then assigned to 4 quadrants. A distinct motor and sensory distribution was observed. The fascicles innervating the thenar eminence and the first lumbrical muscle originated from the nerves' radial parts in 82%. The fascicle supplying the second lumbrical muscle originated from the ulnar side in 78%. No macroscopically visible plexus formation was observed for the distal median nerve in the forearm. The findings on the distribution of the motor branches of the median nerve and the missing plexus formation may likely serve as an anatomical basis for FES of the distal forearm. However, due to the considerable variability of the motor branches, cuff electrodes will need to be adapted individually in FES. Taking into account the sensory distribution of the median nerve, FES may also possibly be applied in the treatment of regional pain syndromes. Copyright © 2013 Elsevier GmbH. All rights reserved.

Find related publications in this database (using NLM MeSH Indexing)

Aged -

Aged, 80 and over -

Anatomy, Cross-Sectional -

Cadaver -

Dissection -

Electric Stimulation -

Female -

Forearm - anatomy & histology

Forearm - innervation

Humans -

Male -

Median Nerve - anatomy & histology

Median Nerve - cytology

Motor Neurons - physiology

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Prosthesis Design -

Sensory Receptor Cells - physiology

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Anatomy

Electrical stimulation

Median nerve fascicles

Prosthesis

Rehabilitation

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