{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:23:32Z","timestamp":1784679812052,"version":"3.55.0"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP 22K09357"],"award-info":[{"award-number":["JP 22K09357"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>This study aimed to histologically investigate whether the compatibility of donor and recipient nerves in distal nerve transfer for radial and ulnar nerve palsy is suitable for restoring nerve function. Partial median to radial nerve transfer for radial nerve palsy and partial median to ulnar nerve transfer for ulnar nerve palsy were performed in 10 cadaveric upper limbs fixed using the Thiel technique. Histological analysis of the nerve samples at the coaptation site focused on the number of myelinated axons. Each recipient and donor nerve was identified in all specimens without any anatomical variations. While median-radial nerve transfer techniques showed an adequate number of donor axons, median-ulnar nerve transfer techniques showed a shortage of donor axons. The insufficiency of donor axons compared to the recipient axons may explain the challenges in reinnervating the recipient muscles. Combining the two different nerve transfers may compensate for the shortage of donor axons and improve motor recovery. Type of study and Level of evidence: Therapeutic, Level III.<\/jats:p>","DOI":"10.1371\/journal.pone.0322331","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T17:22:56Z","timestamp":1746465776000},"page":"e0322331","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Histological study of donor\/recipient feasibility in distal nerve transfer for the upper limb nerve injury"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1066-7015","authenticated-orcid":true,"given":"Akira","family":"Kodama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Kunisaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruyasu","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1276-4879","authenticated-orcid":true,"given":"Shigeki","family":"Ishibashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentarou","family":"Tsuji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Munemori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goki","family":"Kamei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Ikegami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuo","family":"Adachi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,5]]},"reference":[{"issue":"1","key":"pone.0322331.ref001","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/S0363-5023(83)80044-6","article-title":"Extensor carpi radialis brevis tendon transfer for thumb adduction--a study of power pinch","volume":"8","author":"RJ Smith","year":"1983","journal-title":"J Hand Surg Am"},{"issue":"3","key":"pone.0322331.ref002","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/j.1445-2197.1980.tb04115.x","article-title":"Tendon transfers for radial nerve palsy","volume":"50","author":"K Tsuge","year":"1980","journal-title":"Aust N Z J Surg"},{"issue":"4","key":"pone.0322331.ref003","first-page":"1099","article-title":"Current approach to radial nerve paralysis","volume":"110","author":"JB Lowe","year":"2002","journal-title":"Plast Reconstr Surg"},{"issue":"1","key":"pone.0322331.ref004","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/01.sap.0000209028.11153.be","article-title":"Flexor pollicis brevis adductorplasty: an alternative method in ulnar nerve paralysis","volume":"57","author":"M Uralo\u011flu","year":"2006","journal-title":"Ann Plast Surg"},{"issue":"5","key":"pone.0322331.ref005","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/j.jhsa.2019.12.009","article-title":"Nerve Versus Tendon Transfer for Radial Nerve Paralysis Reconstruction","volume":"45","author":"JA Bertelli","year":"2020","journal-title":"J Hand Surg Am"},{"issue":"6","key":"pone.0322331.ref006","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1055\/s-2002-33326","article-title":"Distal anterior interosseous nerve transfer to the deep motor branch of the ulnar nerve for reconstruction of high ulnar nerve injuries","volume":"18","author":"CB Novak","year":"2002","journal-title":"J Reconstr Microsurg"},{"issue":"2","key":"pone.0322331.ref007","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.jhsa.2010.09.034","article-title":"Clinical outcomes following median to radial nerve transfers","volume":"36","author":"WZ Ray","year":"2011","journal-title":"J Hand Surg Am"},{"issue":"6","key":"pone.0322331.ref008","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1053\/jhsu.1999.1185","article-title":"Reconstruction of high ulnar nerve lesions by distal double median to ulnar nerve transfer","volume":"24","author":"B Battiston","year":"1999","journal-title":"J Hand Surg Am"},{"issue":"2","key":"pone.0322331.ref009","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1016\/j.bjps.2021.09.072","article-title":"Outcomes of anterior interosseous nerve transfer to restore intrinsic muscle function after high ulnar nerve injury","volume":"75","author":"SC George","year":"2022","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"6","key":"pone.0322331.ref010","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.jhsa.2020.10.015","article-title":"Effectiveness of Distal Nerve Transfers for Claw Correction With Proximal Ulnar Nerve Lesions","volume":"46","author":"A Arami","year":"2021","journal-title":"J Hand Surg Am"},{"issue":"1","key":"pone.0322331.ref011","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1055\/s-0042-1760097","article-title":"Outcomes after Anterior Interosseous Nerve to Ulnar Motor Nerve Transfer","volume":"18","author":"JN Gross","year":"2023","journal-title":"J Brachial Plex Peripher Nerve Inj"},{"issue":"1","key":"pone.0322331.ref012","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jhsa.2018.09.010","article-title":"Transferring the Motor Branch of the Opponens Pollicis to the Terminal Division of the Deep Branch of the Ulnar Nerve for Pinch Reconstruction","volume":"44","author":"JA Bertelli","year":"2019","journal-title":"J Hand Surg Am"},{"issue":"4","key":"pone.0322331.ref013","first-page":"643","article-title":"Nerve transfers. New options for reconstruction following nerve injury","volume":"15","author":"SE Mackinnon","year":"1999","journal-title":"Hand Clin"},{"issue":"4","key":"pone.0322331.ref014","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.hcl.2008.04.007","article-title":"Nerve fiber transfer by end-to-side coaptation","volume":"24","author":"H Millesi","year":"2008","journal-title":"Hand Clin"},{"issue":"6","key":"pone.0322331.ref015","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1177\/1753193414551909","article-title":"Anatomical and histomorphometric observations on the transfer of the anterior interosseous nerve to the deep branch of the ulnar nerve","volume":"40","author":"TL Schenck","year":"2015","journal-title":"J Hand Surg Eur Vol"},{"issue":"3","key":"pone.0322331.ref016","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1007\/s12565-022-00665-8","article-title":"Guidelines for cadaver dissection in education and research of clinical medicine (The Japan Surgical Society and The Japanese Association of Anatomists)","volume":"97","author":"T Shichinohe","year":"2022","journal-title":"Anat Sci Int"},{"issue":"3","key":"pone.0322331.ref017","first-page":"185","article-title":"The preservation of the whole corpse with natural color","volume":"174","author":"W Thiel","year":"1992","journal-title":"Ann Anat"},{"issue":"3","key":"pone.0322331.ref018","first-page":"267","article-title":"Supplement to the conservation of an entire cadaver according to W. Thiel","volume":"184","author":"W Thiel","year":"2002","journal-title":"Ann Anat"},{"issue":"5","key":"pone.0322331.ref019","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1227\/01.NEU.0000358951.64043.73","article-title":"Distal median to ulnar nerve transfers to restore ulnar motor and sensory function within the hand: technical nuances","volume":"65","author":"JM Brown","year":"2009","journal-title":"Neurosurgery"},{"issue":"6","key":"pone.0322331.ref020","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1177\/1558944720988126","article-title":"Radial Nerve Palsy: Nerve Transfer Versus Tendon Transfer to Restore Function","volume":"17","author":"JMM Patterson","year":"2022","journal-title":"Hand (N Y)"},{"issue":"1","key":"pone.0322331.ref021","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1159\/000102161","article-title":"Maximum number of collaterals developed by one axon during peripheral nerve regeneration and the influence of that number on reinnervation effects","volume":"58","author":"BG Jiang","year":"2007","journal-title":"Eur Neurol"},{"issue":"4","key":"pone.0322331.ref022","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1054\/jhsb.2000.0389","article-title":"Nerve transfer to the median nerve using parts of the ulnar and radial nerves in the rabbit--effects on motor recovery of the median nerve and donor nerve morbidity","volume":"25","author":"BS Lutz","year":"2000","journal-title":"J Hand Surg Br"},{"issue":"1","key":"pone.0322331.ref023","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jhsa.2015.10.015","article-title":"A Cadaver Study of Median-to-Radial Nerve Transfer for Radial Nerve Injuries","volume":"41","author":"K Sukegawa","year":"2016","journal-title":"J Hand Surg Am"},{"issue":"9","key":"pone.0322331.ref024","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1177\/17531934221108459","article-title":"Transfers of the flexor carpi radialis and pronator teres nerves to radial nerve branches: a cadaveric study","volume":"47","author":"A Martins","year":"2022","journal-title":"J Hand Surg Eur Vol"},{"issue":"6","key":"pone.0322331.ref025","first-page":"1044e","article-title":"Upper Extremity Axon Counts and Clinical Implications for Motor Nerve Transfer. Plast Reconstr Surg","volume":"144","author":"A Cheah","year":"2019"},{"issue":"5","key":"pone.0322331.ref026","doi-asserted-by":"crossref","first-page":"795","DOI":"10.3171\/jns.2001.94.5.0795","article-title":"Neurotization as an alternative for restoring finger and wrist extension","volume":"94","author":"ME Ust\u00fcn","year":"2001","journal-title":"J Neurosurg"},{"issue":"4","key":"pone.0322331.ref027","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1136\/jnnp.34.4.453","article-title":"Functional compensation in partially denervated muscles","volume":"34","author":"AJ McComas","year":"1971","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"3\u20134","key":"pone.0322331.ref028","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/0361-9230(93)90281-F","article-title":"Recovery potential of muscle after partial denervation: a comparison between rats and humans","volume":"30","author":"T Gordon","year":"1993","journal-title":"Brain Res Bull"},{"issue":"1","key":"pone.0322331.ref029","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s12868-016-0277-4","article-title":"Age-related morphological regression of myelinated fibers and capillary architecture of distal peripheral nerves in rats","volume":"17","author":"M Sakita","year":"2016","journal-title":"BMC Neurosci"},{"issue":"4","key":"pone.0322331.ref030","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/j.1529-8027.2000.00026.x","article-title":"Influence of aging on peripheral nerve function and regeneration","volume":"5","author":"E Verd\u00fa","year":"2000","journal-title":"J Peripher Nerv Syst"},{"issue":"3","key":"pone.0322331.ref031","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s12565-022-00667-6","article-title":"Updates on cadaver surgical training in Japan: a systematic facility at Chiba University","volume":"97","author":"T Suzuki","year":"2022","journal-title":"Anat Sci Int"},{"issue":"5","key":"pone.0322331.ref032","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1007\/s00268-016-3868-4","article-title":"A Multispecialty Evaluation of Thiel Cadavers for Surgical Training","volume":"41","author":"M Yiasemidou","year":"2017","journal-title":"World J Surg"},{"issue":"2","key":"pone.0322331.ref033","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s00276-015-1549-x","article-title":"Brachial plexus 3D reconstruction from MRI with dissection validation: a baseline study for clinical applications","volume":"38","author":"J Van de Velde","year":"2016","journal-title":"Surg Radiol Anat"},{"issue":"9","key":"pone.0322331.ref034","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1007\/s00276-018-2004-6","article-title":"Safe zone for the posterior interosseous nerve with regard to the lateral and posterior approaches to the proximal radius","volume":"40","author":"GM Hohenberger","year":"2018","journal-title":"Surg Radiol Anat"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0322331","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T17:23:04Z","timestamp":1746465784000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0322331"}},"subtitle":[],"editor":[{"given":"Richa","family":"Gupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,5]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0322331","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,5]]}}}