title: Meaningful power grip recovery after salvage reconstruction of a median nerve avulsion injury with a pedicled vascularized ulnar nerve.
abstract: In cases of median nerve injury alongside an unsalvageable ulnar nerve, a vascularized ulnar nerve graft to reconstruct the median nerve is a viable option. While restoration of median nerve sensation is consistently reported, recovery of significant motor function is less frequently observed. The authors report a case involving a previously healthy man who sustained upper arm segmental median and ulnar nerve injuries and, after failure of sural nerve grafts, was treated with a pedicled vascularized ulnar nerve graft to restore median nerve function. Long-term follow-up showed near full fist, with 12 kg of grip strength, key pinch with 1.5 kg of strength and protective sensation in the median nerve distribution. The present case demonstrates that pedicled ulnar vascularized nerve grafts can provide significant improvements to median nerve sensory and motor function in a heavily scarred environment.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia.
authors.forename: Aaron C
authors.initials: AC
authors.lastname: Van Slyke
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia.
authors.forename: Leigh A
authors.initials: LA
authors.lastname: Jansen
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia.
authors.forename: Sally
authors.initials: S
authors.lastname: Hynes
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia.
authors.forename: Jane
authors.initials: J
authors.lastname: Hicks
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia.
authors.forename: Sean
authors.initials: S
authors.lastname: Bristol
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Carr
keywords: Nerve grafts; Peripheral nerve; Reconstruction; St Clair Strange; Upper extremity; Vascularized