Injury to the Human Median and Ulnar Nerves in the Forearm – Analysis of Costs for Treatment and Rehabilitation of 69 Patients in Southern Sweden

2005 ◽  
Vol 30 (1) ◽  
pp. 35-39 ◽  
Author(s):  
H. E. ROSBERG ◽  
K. S. CARLSSON ◽  
S. HÖJGÅRD ◽  
B. LINDGREN ◽  
G. LUNDBORG ◽  
...  
Keyword(s):  
Health Care ◽  
Nerve Injury ◽  
Ulnar Nerve ◽  
Tendon Injuries ◽  
Health Care Sector ◽  
Nerve Injuries ◽  
Southern Sweden ◽  
Factors Affecting ◽  
Factors Associated ◽  
Ulnar Nerve Injury

This study analysed the costs of median and ulnar nerve injuries in the forearm in humans and factors affecting such costs. The costs within the health-care sector and costs of lost production were calculated in 69 patients with an injury to the median and/or ulnar nerve in the forearm, usually caused by glass, a knife, or a razorblade. Factors associated with the variation in costs and outcome were analysed. The total median costs for an employed person with a median and an ulnar nerve injury were EUR 51,238 and EUR 31,186, respectively, and 87% of the total costs were due to loss of production. All costs were higher for patients with concomitant tendon injuries (≥4 tendons). The costs within the health-care sector were also higher for patients who changed work after the injury and if both nerves were injured. Outcome was dependent on age and repair method.

Acellular Nerve Allografts in Major Peripheral Nerve Repairs: An Analysis of Cases Presenting With Limited Recovery

Hand ◽  
2021 ◽  
pp. 155894472110031
Author(s):  
Blair R. Peters ◽  
Matthew D. Wood ◽  
Daniel A. Hunter ◽  
Susan E. Mackinnon
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Ulnar Nerve ◽  
Current Literature ◽  
Axonal Regeneration ◽  
Large Diameter ◽  
Nerve Injuries ◽  
Myelinated Axons ◽  
Acellular Nerve Allograft ◽  
Ulnar Nerve Injury

Background: Acellular nerve allografts have been used successfully and with increasing frequency to reconstruct nerve injuries. As their use has been expanded to treat longer gap, larger diameter nerve injuries, some failed cases have been reported. We present the histomorphometry of 5 such cases illustrating these limitations and review the current literature of acellular nerve allografts. Methods: Between 2014 and 2019, 5 patients with iatrogenic nerve injuries to the median or ulnar nerve reconstructed with an AxoGen AVANCE nerve allograft at an outside hospital were treated in our center with allograft excision and alternative reconstruction. These patients had no clinical or electrophysiological evidence of recovery, and allograft specimens at the time of surgery were sent for histomorphological examination. Results: Three patients with a median and 2 with ulnar nerve injury were included. Histology demonstrated myelinated axons present in all proximal native nerve specimens. In 2 cases, axons failed to regenerate into the allograft and in 3 cases, axonal regeneration diminished or terminated within the allograft. Conclusions: The reported cases demonstrate the importance of evaluating the length and the function of nerves undergoing acellular nerve allograft repair. In long length, large-diameter nerves, the use of acellular nerve allografts should be carefully considered.

Anterior Interosseous Nerve to Ulnar Nerve Transfers: A Systematic Review

2021 ◽  
Author(s):  
Melanie D. Luikart ◽  
Justin M. Kistler ◽  
David Kahan ◽  
Richard McEntee ◽  
Asif M. Ilyas
Keyword(s):  
Grip Strength ◽  
Nerve Injury ◽  
Ulnar Nerve ◽  
Nerve Graft ◽  
Pinch Strength ◽  
Nerve Injuries ◽  
Nerve Transfers ◽  
Strength Recovery ◽  
Anterior Interosseous Nerve ◽  
Ulnar Nerve Injury

Abstract Background There has been an increasing utilization of end-to-end (ETE) and reverse “supercharged” end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfers (NTs) for treatment of high ulnar nerve injury. This study aimed to review the potential indications for, and outcomes of, ETE and SETS AIN–ulnar NT. Methods A literature review was performed, and 10 articles with 156 patients who had sufficient follow-up to evaluate functional outcomes were included. English studies were included if they reported the outcome of patients with ulnar nerve injuries treated with AIN to ulnar motor NT. Outcomes were analyzed based on the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire scores, grip and key pinch strength, and interosseous Medical Research Council–graded motor strength. Comparisons were made using the independent t-test and the chi-square test. No nerve graft control group was required for eligibility. Ulnar nerve injury types varied. Results NT resulted in 77% of patients achieving M3+ recovery, 53.7 ± 19.8 lb grip strength recovery, 61 ± 21% key pinch recovery, and a mean DASH score of 33.4 ± 16. In this diverse group, NT resulted in significantly greater M3+ recovery and grip strength recovery measured in pounds than in the nerve graft/conventional treatment group, and ETE repairs had significantly better outcomes compared with SETS repairs for grip strength, key pinch strength, and DASH scores, but heterogeneity limits interpretation. Conclusion ETE and SETS AIN–ulnar NTs produce significant restoration of ulnar nerve motor function for high ulnar nerve injuries. For ulnar nerve transection injuries at or above the elbow, ETE NT results in superior motor recovery compared with nerve grafting/conventional repair. However, further research is needed to determine the best treatment for other types of ulnar nerve injury and the role of SETS NT.

Ulnar nerve injury with martin-gruber anastomosis

1987 ◽  
Vol 10 (1) ◽  
pp. 37-39 ◽  
Author(s):  
L. Duinslaeger ◽  
A. DeBacker ◽  
L. Ceulemans ◽  
P. Wylock
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Ulnar Nerve Injury

Comparison of Outcome of Lateral Pinning Versus Medial and Lateral Cross Pinning in Childhood Supracondylar Fractures of Humerus

2021 ◽  
Vol 15 (9) ◽  
pp. 2873-2875
Author(s):  
Mudassar Nazzar ◽  
Muhammad Adeel-Ur- Rehman ◽  
Rizwan Anwar ◽  
Omer Farooq Tanveer ◽  
Muhammad Abdul Hanan ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Functional Outcomes ◽  
P Value ◽  
Supracondylar Fractures ◽  
Group I ◽  
Pin Fixation ◽  
Group Ii ◽  
Carrying Angle ◽  
Ulnar Nerve Injury

Objectives: To compare the complications and outcomes of lateral entry pin fixation with medial and lateral pin fixation for Gartland type III supracondylar fractures of humerus. Methodology: This prospective comparative study involving 190 patients of Gartland type III close supracondylar fractures were included. from March-2019 to Dec-2020. In all patients, initially the elbow was mobilized using the splint placed above the elbow joint at 30 to 45 degrees’ flexion. After closed reduction, lateral pinning was applied in group I and in group II lateral and medial cross pinning was applied using the standard protocol. Patients were followed for iatrogenic ulnar nerve injury, radiologic and function outcomes in-terms of loss of reduction, elbow range of motion, loss in carrying angle and functional outcomes. Results: The two groups were comparable for loss of elbow range of motion, loss of carrying angle and loss of Bauman's angle. On clinical examination, immediate post-operative ulnar nerve injury was diagnosed in 4 (4.2%) cases in group II and in no patient in group I (p-value 0.12). Satisfactory functional outcomes were achieved in 85 (89.5%) patients in group I and in 88 (92.6%) patients in group II (p-value 0.44). Conclusion: Lateral pinning provided stable fixation clinically and radiologically as compared to lateral and medial cross pinning. Keywords: Supracondylar fracture of Humerus, Iatrogenic ulnar nerve injury, Lateral pin entry, lateral and medial cross pin entry.

Electromyography and Ultrasonography in the Diagnosis of A Rare Double-Crush Ulnar Nerve Injury

2011 ◽  
Vol 92 (11) ◽  
pp. 1914-1916 ◽  
Author(s):  
Mufit Akyuz ◽  
Elif Yalcin ◽  
Barin Selcuk ◽  
Burcu Onder ◽  
Levent Özçakar
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Ulnar Nerve Injury ◽  
Double Crush
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