Original CommunicationsClinical application of intraoperative measurement of choline acetyltransferase activity during functioning free muscle transfer*,**
Section snippets
Technique of CAT activity measurement
The formation of acetylcholine labeled with 14C from choline and acetyl-coenzyme A labeled with 14C was used to assess CAT activity.
Each nerve sample was divided into fascicles and tagged with varying lengths of 10-0 monofilament nylon stitches to keep track of the individual fascicles. A 1.5-mm-long specimen was resected from each fascicle; CAT activity was then measured according to the modified method of Engel et al.2 The sample was put into a plastic microtube containing 20 μL buffer A (50
Results
All transferred muscles survived without any postoperative vascular complications. The results of CAT activity in donor fascicles are listed in Table 1. The fascicles that had greater than 2,000 cpm CAT activity were used as donor motor fascicles under our previously described criteria.5 The CAT activity of donor fascicles ranged from 2,094 to 5,499 cpm with a mean activity of 2,832 ± 874 (mean ± SD) cpm. One fascicle was used as a donor motor fascicle in 4 cases and 2 fascicles in 8 cases. All
Discussion
The functional outcome after FFMT depends on the quality of the donor nerves, patient's age, and postoperative complications.8, 9 More motor fascicles in the donor nerves are associated with stronger recovery of the transferred muscle. We preliminarily reported the usefulness of CAT activity measurement in evaluating the functional status of donor nerves when the quality of the donor nerve is in doubt.6 We had hypothesized that the fascicles with CAT activity greater than 2,000 cpm were
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Cited by (20)
Treatment approach to isolated common peroneal nerve palsy by mechanism of injury: Systematic review and meta-analysis of individual participants’ data
2022, Journal of Plastic, Reconstructive and Aesthetic SurgeryTechniques for Intraoperative Peripheral Nerve Assessment and Implications for Treatment
2015, Nerves and Nerve InjuriesForce recovery assessment of functioning free muscle transfers using ultrasonography
2014, Journal of Hand SurgeryCitation Excerpt :Our findings demonstrated that innervation by the SAN results in stronger recovery. The experimental study by Hattori et al19 evaluated functional motor status by determining the choline acetyltransferase activity and found that the SAN has a greater number of motor fascicles than the ICNs. Our study has several limitations.
Adult brachial plexus injury. Evaluation and management.
2013, Orthopedic Clinics of North AmericaFree Functional Muscle Transfer for the Upper Extremity
2011, Clinics in Plastic SurgeryCitation Excerpt :For successful FFMT, the donor nerve must be a pure motor nerve, with no surrounding scar tissue, and ideally with a synergistic function to the muscle the transfer is replacing. If there is any question on the viability of the donor nerve, an intraoperative biopsy should be performed to confirm its health.35 This action is undertaken before the functional muscle is harvested.
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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
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Reprint requests: Yasunori Hattori, MD, PhD, Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, 862-3, Shimogo, Ogori, Yoshiki-gun, Yamaguchi, Japan 754-0002.