Direct radial to ulnar nerve transfer to restore intrinsic muscle function in combined proximal median and ulnar nerve injury: case report and surgical technique.
A distal median to ulnar nerve transfer for timely restoration of critical intrinsic muscle function is possible in isolated ulnar nerve injuries but not for combined ulnar and median nerve injuries. We used a distal nerve transfer to restore ulnar intrinsic function in the case of a proximal combined median and ulnar nerve injury. Transfer of the nonessential radial nerve branches to the abductor pollicis longus, extensor pollicis brevis, and extensor indicis proprius to the motor branch of the ulnar nerve was performed in a direct end-to-end fashion via an interosseous tunnel. This method safely and effectively restored intrinsic function before terminal muscle degeneration.
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Saint Louis, MO.
Benjamin Z
BZ
Phillips
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Saint Louis, MO.
Michael J
MJ
Franco
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Saint Louis, MO.
Andrew
A
Yee
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Saint Louis, MO.
Thomas H
TH
Tung
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Saint Louis, MO.
Susan E
SE
Mackinnon
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Saint Louis, MO. Electronic address: foxi@wudosis.wustl.edu.
Ida K
IK
Fox
D000293:Adolescent; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000293:injuries / Q000601:surgery*; D009104:Multiple Trauma / Q000175:diagnosis / Q000601:surgery; D018482:Muscle, Skeletal / Q000294:innervation / Q000601:surgery; D009416:Nerve Regeneration / Q000502:physiology; D016067:Nerve Transfer / Q000379:methods*; D059348:Peripheral Nerve Injuries / Q000175:diagnosis / Q000601:surgery*; D011826:Radial Nerve / Q000601:surgery / Q000637:transplantation*; D020127:Recovery of Function; D018570:Risk Assessment; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000293:injuries / Q000601:surgery*
Intrinsic function; median nerve; nerve transfer; ulnar nerve