Two applications of end-to-side nerve neurorrhaphy in severe upper-extremity nerve injuries.
End-to-side and side-to-side techniques (what we call alternative nerve repair techniques) have been investigated in detail in both experimental and clinical studies. There have not been any large series, but only some case reports describing either successful or disappointing functional results in the recent literature. Two cases presented here were of two extreme examples of nerve injuries that had no chance for direct repair; alternative choices were performed. One was a side-to-side neurorrhaphy between the ulnar and median nerves, and the other was an end-to-side nerve repair of the median and radial nerves to the ulnar nerve. Both patients regained their diminished protective sensation and returned to their occupations. Based on these results and our review of the current literature, we consider alternative nerve repair techniques to be reasonable, prudent, and scientific choices for the treatment of some challenging nerve injury cases.
Yüksel
Fuat
F
Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Haydarpaşa Hospital, Usküdar, Istanbul, Turkey 34668. fuatyuk@superonline.com
Peker
Fatih
F
Celiköz
Bahattin
B
D000062:Accidents, Occupational; D000063:Accidents, Traffic; D000328:Adult; D000714:Anastomosis, Surgical; D004576:Electromyography; D006230:Hand Injuries / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008475:Median Nerve / Q000293:injuries / Q000601:surgery*; D018482:Muscle, Skeletal / Q000294:innervation*; D009416:Nerve Regeneration; D009431:Neural Conduction; D019635:Neurosurgical Procedures / Q000379:methods; D011826:Radial Nerve / Q000293:injuries / Q000601:surgery*; D011877:Radionuclide Imaging; D020127:Recovery of Function; D018570:Risk Assessment; D016378:Tissue Transplantation; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000293:injuries / Q000601:surgery*; D034941:Upper Extremity / Q000000981:diagnostic imaging