Distal Anterior Interosseous Nerve Transfer to the Deep Motor Branch of the Ulnar Nerve for Reconstruction of High Ulnar Nerve Injuries

2002 ◽  
Vol 18 (6) ◽  
pp. 459-464 ◽  
Author(s):  
Christine B. Novak ◽  
Susan E. Mackinnon
Keyword(s):  
Ulnar Nerve ◽  
Nerve Transfer ◽  
Nerve Injuries ◽  
Motor Branch ◽  
Anterior Interosseous Nerve

scholarly journals Distal anterior interosseous nerve transfer to the deep ulnar nerve and end-to-side suture of the superficial ulnar nerve to the third common palmar digital nerve for treatment of high ulnar nerve injuries: experience in five cases

2011 ◽  
Vol 69 (3) ◽  
pp. 519-524 ◽  
Author(s):  
Leandro Pretto Flores
Keyword(s):  
Ulnar Nerve ◽  
Nerve Transfer ◽  
Sensory Function ◽  
Digital Nerve ◽  
Nerve Injuries ◽  
The Third ◽  
Distal Branch ◽  
Anterior Interosseous Nerve ◽  
Sensory Recovery ◽  
Protective Sensation

OBJECTIVE: To demonstrate the results of a double nerve transfer at the level of the hand for recovery of the motor and sensory function of the hand in cases of high ulnar nerve injuries. METHOD: Five patients underwent a transfer of the distal branch of the anterior interosseous nerve to the deep ulnar nerve, and an end-to-side suture of the superficial ulnar nerve to the third common palmar digital nerve. RESULTS: Two patients recovered strength M3 and three cases were graded as M4; recovery of protective sensation (S3+ in three patients and S4 in two) was observed in the fourth and fifth fingers, and at the hypothenar region. The monofilament test showed values of 3.61 or less in all cases and the two-point discrimination test demonstrated values of 7 mm in three cases and 5 mm in two. CONCLUSION: This technique of double nerve transfer is effective for motor and sensory recovery of the distal ulnar-innervated side of the hand.

DISTAL MEDIAN TO ULNAR NERVE TRANSFERS TO RESTORE ULNAR MOTOR AND SENSORY FUNCTION WITHIN THE HAND

Neurosurgery ◽  
2009 ◽  
Vol 65 (5) ◽  
pp. 966-978 ◽  
Author(s):  
Justin M. Brown ◽  
Andrew Yee ◽  
Susan E. Mackinnon
Keyword(s):  
Ulnar Nerve ◽  
Case Reports ◽  
Nerve Transfer ◽  
Sensory Function ◽  
Wrist Flexion ◽  
Nerve Injuries ◽  
Motor Branch ◽  
Nerve Transfers ◽  
Ulnar Nerve Palsy ◽  
Intrinsic Function

Abstract ULNAR NERVE INJURIES can be severely debilitating and result in weakness of wrist flexion, loss of hand intrinsic function, and ulnar-sided hand anesthesia. When these injuries produce a Sunderland fourth- or fifth-degree injury, surgical intervention is necessary for functional recovery. Traditional methods for restoring hand intrinsic function after ulnar nerve palsy include interposition nerve grafting for timely presentations or tendon transfers for either complex injuries or late presentations. Distal median to ulnar nerve transfer to restore ulnar intrinsic nerve muscle function was first performed in 1991. We continue to find it advantageous for recovery of ulnar intrinsic function in patients with proximal ulnar nerve injuries by significantly reducing denervation time and directing motor fibers into this critical motor distribution. Several case reports have been published discussing the concept behind this approach, but none have outlined the specific steps involved in this operation. As such, this article discusses our operative methodology behind the distal median to ulnar neurotization, which includes a Guyon canal release, identification of donor median and recipient ulnar nerve fascicular anatomy within the forearm, and an operative tutorial on proper technique for neurotization to restore both ulnar motor and sensory function. We present the technical nuances of the following nerve transfers to restore ulnar nerve function within the hand: anterior interosseous nerve to deep motor branch of ulnar nerve, third webspace sensory contribution of median nerve to volar sensory component of ulnar nerve, and end-to-side reinnervation of ulnar dorsal cutaneous to the remaining median sensory trunk.

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