Purpose
To compare combined ulnar nerve repair with supercharged end-to-side anterior interosseous
nerve to ulnar motor nerve transfer (UR+SETS) with conventional isolated ulnar repair
techniques in proximal ulnar nerve transection, with respect to intrinsic muscle power
recovery and claw hand deformity correction.
Methods
We conducted a comparative matched-paired series prospectively on 21 patients with
proximal ulnar nerve transection injury. Eleven patients were managed by UR+SETS and
10 by isolated ulnar repair. The outcome was reported at 3, 6, 12, and 18 months using
the score of Birch and Raji and Brand’s criteria.
Results
A total of 21 patients with acute proximal ulnar nerve transection injury had completed
18 months’ follow-up. We observed better results in the UR+SETS group regarding the
return of intrinsic function and reduction of deformity with earlier improvement in
the score of Birch and Raji and Brand’s criteria.
Conclusions
In the short term, UR+SETS transfer appears to result in better intrinsic muscle reinnervation
and clawing deformity correction after proximal ulnar nerve transection injury.
Type of study/level of evidence
Therapeutic II.
Key words
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References
- Surgical outcomes of 654 ulnar nerve lesions.J Neurosurg. 2003; 98: 993-1004
- Median and ulnar nerve injuries: a meta-analysis of predictors of motor and sensory recovery after modern microsurgical nerve repair.Plast Reconstr Surg. 2005; 116: 484-496
- Distal anterior interosseous nerve transfer to the deep motor branch of the ulnar nerve for reconstruction of high ulnar nerve injuries.J Reconstr Microsurg. 2002; 18: 459-464
- Transfer of a branch of the anterior interosseus nerve to the motor branch of the median nerve and ulnar nerve.Chin Med J (Engl). 1997; 110: 216-219
- Nerve fiber transfer by end-to-side coaptation.Hand Clin. 2008; 24: 461-483
- Reverse end-to-side neurotization in a regenerating nerve.J Reconstr Microsurg. 2008; 24: 489-496
- Reverse end-to-side nerve transfer: from animal model to clinical use.J Hand Surg Am. 2011; 36: 1631-1639.e2
- Supercharge nerve transfer to enhance motor recovery: a laboratory study.J Hand Surg Am. 2013; 38: 466-477
- Supercharged end-to-side anterior interosseous to ulnar motor nerve transfer for intrinsic musculature reinnervation.J Hand Surg Am. 2012; 37: 2150-2159
- CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials.BMJ. 2010; 340: c332
- Comparison of magnification in primary digital nerve repair: literature review, survey of practice trends, and assessment of 90 cadaveric repairs.J Hand Surg Am. 2013; 38: 2144-2150
- Repair of median and ulnar nerves: primary suture is best.J Bone Joint Surg Br. 1991; 73: 154-157
- Paralytic claw hand; with special reference to paralysis in leprosy and treatment by the sublimis transfer of Stiles and Bunnell.J Bone Joint Surg Br. 1958; 40: 618-632
- Surgical repair of ulnar nerve lesions caused by gunshots and shrapnel: results in 407 lesions.J Neurosurg. 2007; 107: 776-783
- Ulnar nerve laceration and repair.Hand Clin. 2007; 23: 291-299
- Nerve reconstruction in the hand and upper extremity.Clin Plast Surg. 2011; 38: 643-660
- Reconstruction of high ulnar nerve lesions by distal double median to ulnar nerve transfer.J Hand Surg Am. 1999; 24: 1185-1191
- Nerve transfers in the upper extremity.Hand Clin. 2000; 16: 131-139
- The supercharge end-to-side anterior interosseous-to-ulnar motor nerve transfer for restoring intrinsic function: clinical experience.Plast Reconstr Surg. 2015; 136: 344-352
- Comparison of ulnar intrinsic function following supercharge end-to-side anterior interosseous–to-ulnar motor nerve transfer: a matched cohort study of proximal ulnar nerve injury patients.Plast Reconstr Surg. 2016; 138: 1264-1272
- Surgical Disorders of the Peripheral Nerves.Edinburgh: Churchill Livingstone. 1971;
Article info
Publication history
Published online: December 19, 2019
Accepted:
November 6,
2019
Received:
December 26,
2017
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
