title: Brachial artery perforator-based propeller flap coverage for prevention of readhesion after ulnar nerve neurolysis.
abstract: It is difficult for most plastic and orthopaedic surgeons to treat nerve dysfunction related to neural adhesion because the pathophysiology and suitable treatment have not been clarified. In the current report, we describe our experience of surgical treatment for adhesive ulnar neuropathy. A 58-year-old male complained of pain radiating to the ulnar nerve-innervated area during elbow and wrist motion caused by adhesive ulnar neuropathy after complex open trauma of the elbow joint. The patient obtained a good clinical outcome by surgical neurolysis of the ulnar nerve combined with a brachial artery perforator-based propeller flap to cover the soft tissue defect after resection of the scar tissue and to prevent readhesion of the ulnar nerve. This flap may be a useful option for ulnar nerve coverage after neurolysis without microvascular anastomosis in specific cases.
authors.affiliation: Department of Orthopaedic Surgery, Kushiro Rosai Hospital Hand Center, Kushiro, Japan.
authors.forename: Hirotake
authors.initials: H
authors.lastname: Sekiguchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Motomiya
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sakurai
authors.forename: Dai
authors.initials: D
authors.lastname: Matsumoto
authors.forename: Tadanao
authors.initials: T
authors.lastname: Funakoshi
authors.forename: Norimasa
authors.initials: N
authors.lastname: Iwasaki
mesh_terms: D001916:Brachial Artery; D003714:Denervation; D006801:Humans; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply; D019651:Plastic Surgery Procedures / Q000379:methods*; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery; D014459:Ulnar Nerve / Q000601:surgery*; D020424:Ulnar Neuropathies / Q000209:etiology / Q000601:surgery*; D000092464:Elbow Injuries