Background: High ulnar nerve injuries is known to have unfavorable motor outcomes compared to other peripheral nerve injuries in the upper extremity. Functional muscle recovery after peripheral nerve injury depends on the time to motor end plate reinnervation and the number of motor axons that successfully reach the target muscle. The purpose of this study is to assess the functional recovery, and complications following performing supercharge end-to-side (SETS) anastomosis for proximal ulnar nerve injuries. Our study focuses on the role of SETS in the recovery process of high ulnar nerve injury.
Patient And Methods: This study is a prospective, single-arm, open-label, case series. The original proximal nerve pathology was dealt with according to the cause of injury, then SETS was performed distally. The follow-up period was 18 months. We compared the neurological findings before and after the procedure. A new test was used to show the effect of SETS on recovery by performing a Lidocaine proximal ulnar nerve block test.
Results: Recovery of the motor function of the ulnar nerve was evident in 33 (86.8%) patients. The mean time to intrinsic muscle recovery was 6.85 months ± 1.3, only 11.14% of patients restored protective sensation to the palm and finger and 86.8% showed sensory level at the wrist level at the end of the follow-up period. Lidocaine block test was performed on 35 recovered patients and showed no change in intrinsic hand function in 31 patients.
Conclusion: SETS exhibit a remarkable role in the treatment of high ulnar nerve damage. SETS transfer can act as a nerve transfer that can supply intrinsic muscles by its fibers and allows for proximal nerve regeneration. We believe that this technique improves recovery of hand motor function and allows recovery of sensory fibers when combined with treating the proximal lesion.
Trial Registration: Approved by Research Ethics Committee of Faculty of Medicine- Cairo University on 01/09/2021 with code number: MD-215-2021.
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http://dx.doi.org/10.1186/s12891-024-07650-4 | DOI Listing |
J Hand Surg Eur Vol
January 2025
Hand and Reconstructive Unit, Department of Orthopedics, Faculty of Medicine, Khon Kaen University, 123 Mitraphap Road, Khon Kaen 40002, Thailand.
The study evaluates the forced small finger abduction test for assessing the strength of intrinsic muscles innervated by the ulnar nerve. The test was performed on healthy and ulnar neuropathy patients. Results demonstrate its ability to detect intrinsic weakness, which may enhance diagnosis of ulnar neuropathy.
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January 2025
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Background: The aim of surgical treatment for posterolateral rotatory instability (PLRI) of the elbow is to restore the integrity of the lateral ulnar collateral ligament (LUCL), with ligamentous reconstruction being the preferred option for recurrent symptomatic PLRI. However, there is no clinical evidence demonstrating the superiority of reconstruction versus repair. Treatment options currently depend on the cause of the LUCL injury and surgeon preference.
View Article and Find Full Text PDFArthrosc Tech
December 2024
Orlin & Cohen Orthopedic Group, Smithtown, New York, U.S.A.
Direct repair of ulnar collateral ligament (UCL) injuries with suture augmentation has been successful in properly selected patients lacking chronic attritional wear of the medial elbow. Described is a Speed-Fix technique for direct UCL repair using SutureTape, with Brace augmentation. The Speed-Fix repair technique uses an inverted mattress knotless repair with a knotless SwiveLock anchor and FiberTape suture, which allows for theoretical compression at the repair site.
View Article and Find Full Text PDFJ Hand Surg Am
January 2025
Department of Neurosurgery, Nossa Senhora da Conceição Hospital, Tubarão, Brazil.
Purpose: Brachial plexus traction injuries have conventionally been categorized as involving the C5-C6, C5-C7, C5-T1, and C8-T1 roots. In this article, we report a distinct clinical presentation of brachial plexus injury characterized by intact finger flexion with signs of complete brachial plexus injury.
Methods: From 2010 to 2022, 989 patients who sustained brachial plexus injuries were examined and underwent surgery.
Neurospine
December 2024
Departement of Neurosurgery, Sion Cantonal Hospital, Wallis, Switzerland.
The main objective of this case and video is to demonstrate the surgical technique of navigated full-endoscopic decompression and sequestrectomy at the C7-T1 level to alleviate C8 nerve root compression and manage cervicobrachialgia. Cervicobrachialgia resulting from C7-T1 disc herniation is a quite rare yet painful condition that can significantly impair motor function in the upper limb. Traditionally, open surgeries can be invasive, with prolonged recovery times and/or fusion of the level with adjacent segment disease.
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