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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
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"Sensory Switching" in Elbow Reconstruction.

Shunsuke Sakakibara1, Kazunobu Hashikawa1, Hiroto Terashi1

  • 1Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Journal of Brachial Plexus and Peripheral Nerve Injury
|December 6, 2016
PubMed
Summary

Elbow reconstruction using specific flaps led to a unique "sensory switching" phenomenon. Sensation in the reconstructed area unexpectedly shifted to the elbow region months after surgery.

Keywords:
elbow reconstructionsensory nervesensory reconstructionsensory switchingsensory territory

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Neurosensory Research

Background:

  • Elbow soft tissue defects often require flap reconstruction due to the region's thin soft tissue coverage.
  • Restoring tactile sensation in the elbow is crucial for its anatomical and functional recovery.

Purpose of the Study:

  • To describe and discuss the phenomenon of

Main Methods:

  • Reconstruction of elbow defects in three patients using different flap techniques.
  • One patient received a pedicled island forearm flap with the lateral cutaneous nerve of the forearm.
  • Two patients underwent reconstruction with venoneuro-accompanying artery fasciocutaneous flaps (VNAF flaps), one incorporating the basilic vein and the other the cephalic vein.

Main Results:

  • All three cases exhibited a distinct sensory change approximately 4 to 6 months post-surgery.
  • Patients reported a sudden shift in sensation from the flap's original territory to the elbow region.
  • This sensory alteration was confirmed through tactile testing with the patients' eyes closed, termed 'sensory switching'.

Conclusions:

  • The study introduces and discusses the novel concept of 'sensory switching' following elbow reconstruction.
  • This phenomenon highlights potential neuroplasticity and sensory reorganization after reconstructive surgery in the elbow.
  • Further research is warranted to understand the mechanisms and implications of sensory switching in reconstructive surgery.