The Long Term Recovery Curve in Adults after Median or Ulnar Nerve Repair: A Reference Interval

2001 ◽  
Vol 26 (3) ◽  
pp. 196-200 ◽  
Author(s):  
B. ROSÉN ◽  
G. LUNDBORG
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Nerve Repair ◽  
Reference Interval ◽  
Recovery Curve ◽  
Score Analysis ◽  
Sensory Motor ◽  
Ulnar Nerve Injury

This study presents a predicted five-year reference interval for the outcome following repair of the median or ulnar nerve in adults. Forty-four patients were examined with the use of a recently introduced model instrument for documentation after nerve repair that includes “sensory”, “motor”, and “pain/discomfort” outcomes which together constitute a summarized “total score”. Analysis of the “total score” showed that follow-up time and age significantly influence the outcome. There were obvious inferior “motor” results after ulnar nerve injury, but these did not significantly influence the “total score”. Significant improvements in the “total score” were seen throughout the follow-up period.

Missile-caused Ulnar Nerve Injuries: Outcomes of 128 Repairs

Neurosurgery ◽  
2004 ◽  
Vol 55 (5) ◽  
pp. 1120-1129 ◽  
Author(s):  
Zoran Roganovic
Keyword(s):  
Median Nerve ◽  
Nerve Injury ◽  
Ulnar Nerve ◽  
Nerve Repair ◽  
Successful Outcome ◽  
Neurosurgical Department ◽  
Military Medical Academy ◽  
Ulnar Nerve Injury ◽  
High Level ◽  
Sensorimotor Recovery

Abstract OBJECTIVE: This prospective study presents repair results after missile-caused ulnar nerve ruptures as well as factors influencing the outcomes. METHODS: Between 1991 and 1994, 128 casualties with missile-caused complete ulnar nerve injury were managed surgically in the Neurosurgical Department of the Belgrade Military Medical Academy. At least 4 years after surgery, we scored sensorimotor recovery, neurophysiological recovery, and patient judgment of the outcome. On the basis of the total score, we defined the final outcome as poor, insufficient, good, or excellent. The last two outcomes were considered to be successful. RESULTS: A successful outcome was obtained in 0% of high-level, 33.8% of intermediate-level, and 77.3% of low-level repairs (P< 0.001). On average, the nerve defect, preoperative interval, and patient age were lower for patients with a successful outcome than for those with an unsuccessful outcome (P= 0.004, P= 0.032, and P= 0.003, respectively). Worsening of the outcome was related to nerve defect longer than 4.5 cm, preoperative interval longer than 5.5 months, and age older than 23 years (P= 0.002, P= 0.034, and P= 0.023, respectively). A successful outcome occurred in 48.8% of patients repaired with direct suture and in 41.2% of patients repaired with a nerve graft (P> 0.05). A successful outcome also occurred 22.2% of combined ulnar-median nerve repairs and in 49.5% of isolated ulnar nerve repairs (P= 0.011). Repair level (P< 0.001), preoperative interval (P= 0.001), length of the nerve defect (P< 0.001), and associated median nerve rupture (P= 0.028) were independent predictors of a successful outcome. CONCLUSION: The outcome of ulnar nerve repair depends significantly on the repair level, preoperative interval, associated median nerve injury, length of the nerve defect, and age of the patient. High-level ulnar nerve repair is probably useless if performed in the classic manner.

Tubular Repair of the Median or Ulnar Nerve in the Human Forearm: A 5-Year Follow-Up

2004 ◽  
Vol 29 (2) ◽  
pp. 100-107 ◽  
Author(s):  
G. LUNDBORG ◽  
B. ROSÉN ◽  
L. DAHLIN ◽  
J. HOLMBERG ◽  
I. ROSÉN
Keyword(s):  
Ulnar Nerve ◽  
Nerve Repair ◽  
Term Outcome ◽  
Cold Intolerance ◽  
Long Term Outcome ◽  
Clinical Assessments ◽  
Significant Difference ◽  
Human Forearm

The long-term outcome from silicone tube nerve repair was compared with the outcome from routine microsurgical repair in a clinical randomized prospective study, comprising 30 patients with median or ulnar nerve injuries in the distal forearm. Postoperatively, the patients underwent neurophysiological and clinical assessments of sensory and motor function regularly over a 5-year period. After 5 years there was no significant difference in outcome between the two techniques except that cold intolerance was significantly less severe with the tubular technique. In the total group there was ongoing improvement of functional sensibility throughout the 5 years after repair. It is concluded that tubular repair of the median and ulnar nerves is at least as good as routine microsurgical repair, and results in less cold intolerance.

Clinical and electroneurographic evaluation of sensory/motor-differentiated nerve repair in the hand

1993 ◽  
Vol 78 (5) ◽  
pp. 709-713 ◽  
Author(s):  
Maria Deutinger ◽  
Werner Girsch ◽  
Georg Burggasser ◽  
Alfred Windisch ◽  
Norbert Mayr ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Nerve Repair ◽  
Hand Function ◽  
Acetylcholinesterase Activity ◽  
Content Type ◽  
Upper Limit ◽  
Sensory Motor ◽  
Fine Print

✓ In 17 patients acetylcholinesterase activity was used to differentiate between sensory and motor fascicles in median and ulnar nerve repair of the hand. Eleven patients received follow-up evaluation 1 to 11 years after surgery, and at that time clinical and electroneurographic examinations were performed to evaluate the techniques. Clinical examination showed that four patients had regained on average 71.9% of hand function after median nerve repair, one patient had regained 83.6% of hand function after ulnar nerve repair, four patients had regained on average 53.3% of hand function after median and ulnar nerve repair, and two patients had regained on average 43.5% of hand function after median and partial ulnar nerve repair. The contribution of the ulnar nerve to reinnervation of the thenar muscles was 68.5%, whereas the median nerve did not contribute to reinnervation of the hypothenar muscles. Distal latencies for the median nerve showed a delay of 36% of the upper limit of normal value, and those for the ulnar nerve revealed a delay of 21.5%. This study demonstrated that sensory/motor-differentiated nerve repair of the median and ulnar nerves is possible and can be proven electroneurographically.

Direct End-to-End Neurorrhaphy for Wrist-Level Long Nerve Defect with Fixation of the Wrist in Flexion: Technique Note

2021 ◽  
Author(s):  
Chun-Ching Lu ◽  
Hui-Kuang Huang ◽  
Jung-Pan Wang
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Nerve Graft ◽  
Sensory Function ◽  
Wrist Flexion ◽  
Tension Free ◽  
End To End ◽  
Ulnar Nerve Injury ◽  
K Wires

Abstract Background For a nerve gap, end-to-end neurorrhaphy would either be difficult or would include tension. The use of a nerve graft or conduit could be a solution, but it might compromise the reinnervation. We describe a method for wrist-level ulnar and/or median long nerve injury by fixing the wrist in the flexion position with K-wire (s) to make possible an end-to-end and tension-free neurorrhaphy. Patients and Methods Two patients had wrist-level ulnar nerve injury for 2 and 3 months and nerve gaps of 2.5 cm and 3.5 cm, respectively, after the neuroma excision. K-wires were used to transfix from the radius to carpal bones, in order to keep their wrists in flexion of 45 and 65 degrees, respectively, with which the tension-free end-to-end neurorrhaphy could be achieved. The K-wires were removed in 6 weeks after surgery, and their wrists were kept in the splint for a progressive extension program. Results Both patients were noted to have an improved claw hand deformity 4 months after the surgery. The ulnar nerve motor and sensory function could be recovered mostly in the 12-month follow-up. The wrist flexion and extension motion arc both achieved, at least, 150 degree in the 12-month follow-up. There were no complications related to the K-wire fixation. Conclusion With the wrist fixed in a flexed position, maintaining a longer nerve gap to achieve a direct end-to-end and tension-free neurorrhaphy would be more likely and safer. Without the use of nerve graft, innervation of the injured nerve would be faster.

Long-term voice quality outcome after thyroidectomy without laryngeal nerve injury: a prospective 10 year follow up study

2021 ◽  
pp. 106109
Author(s):  
Evelien D'haeseleer ◽  
Wouter Huvenne ◽  
Hubert Vermeersch ◽  
Iris Meerschman ◽  
Kissel Imke ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Voice Quality ◽  
Laryngeal Nerve ◽  
Follow Up Study ◽  
Laryngeal Nerve Injury

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.

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