scholarly journals Immediate Tendon Transfer with Nerve Repair in Low Combined Ulnar and Median Nerve Injury

2021 ◽  
Vol 9 (5) ◽  
pp. e3597
Author(s):  
Khaled A. Reyad ◽  
Ahmed M. Behiri ◽  
Karim K. El Lamie ◽  
Mohamed A. Sayed ◽  
Hala M. Abd Elsabour Sabah
Keyword(s):  
Median Nerve ◽  
Nerve Injury ◽  
Tendon Transfer ◽  
Nerve Repair ◽  
Median Nerve Injury

scholarly journals Surgical outcome of prognostic factors for final outcome of hand function following primary median nerve repair

2018 ◽  
Vol 5 (11) ◽  
pp. 3672
Author(s):  
S. Dhanaraju ◽  
N. Kannan
Keyword(s):  
Prognostic Factors ◽  
Median Nerve ◽  
Nerve Injury ◽  
Functional Recovery ◽  
Nerve Repair ◽  
Hand Function ◽  
Tendon Injury ◽  
Final Outcome ◽  
Nerve Injuries ◽  
Median Nerve Injury

Background: A major problem in surgery of median nerve injuries is the unpredictable final outcome, so identifying the prognostic factors for final outcome is needed in primary median nerve repair following injury. Assessing the functional recovery of hand function following median nerve repair.Methods: Total no. of patients with median nerve injury repaired in our institution was 70. All the patients assessed preoperatively by clinical examination, surgery performed immediately or within 12 hours of injury, performed under axillary block and tourniquet control, Multiple surgeons involved (about 6 surgeons). All are primarily repaired nerves, repair by 70 prolene epineural sutures, postoperative immobilization of 3 weeks.Results: Median nerve injury associated with other flexors involved patients show good functional recovery, the functional recovery deteriorate once involvement of finger flexors, particularly if all the tendons were injured. The arterial injury and repair don’t seem to influence the outcome of the hand function, but both artery involvement usually associated with all tendon injury, it shows poor outcome.Conclusions: The more distal the injury the outcome will be quicker as compared to middle 1/3 and proximal 1/3 injuries. Pure median nerve injuries sensory recovery in S4 grade about 5%, S3+ recovery of sensation is about 36%. Pure median nerve injury patients M4 motor recovery about 54%.Only median nerve injury the final outcome is good but combined median and ulnar nerve injury and associated tendon injury the outcome is poor. 

scholarly journals Surgical treatment of the consequences of the computed damage of the median nerve in the proximal part of the upper limb

2018 ◽  
Vol 22 (1) ◽  
pp. 133-139
Author(s):  
I.B. Tretyak ◽  
I.V. Kovalenko ◽  
A.I. Tretyakova ◽  
A.A. Gatskiy ◽  
A.N. Bazik
Keyword(s):  
Median Nerve ◽  
Nerve Injury ◽  
Functional Outcomes ◽  
Tendon Transfer ◽  
Proximal Part ◽  
Surgical Reconstruction ◽  
Anterior Surface ◽  
Nerve Injuries ◽  
Muscle Complex ◽  
Median Nerve Injury

Aim of the study – to assess the efficacy of surgical reconstruction of the combined proximal median nerve injuries, to evaluate the efficacy of the staged orthopedic reconstruction of the thumb opposition. The retrospective analysis of the reconstruction of 14 proximal median nerve injuries was conducted. 11 men and 3 women were enrolled into the study, mean age of participants was 42,3 years. In all cases proximal median nerve injury was accompanied by either axillary (4 cases) or brachial artery (10 cases) injury. 5 patients received direct repair of the median nerve. 9 patients received autologous grafting of the median nerve with mean gap between the stumps 7,5 cm. Both motor and sensory components of recovery were evaluated with MRC Scale and Seddon Scale respectively. Each patient evaluated the recovered median nerve mediated functions with Brief Michigan Hand Questionnaire. 14 cases with poor or no recovery of thenar muscles required tendon transfer (Bunne’sl transfer) to restore thumb opposition in later terms. Mean terms of recovery of the entire muscle-complex of the anterior surface of the forearm in all 14 patients with proximal median nerve injury was 12,9 months (with no reliable dependence on method of reconstruction). Mean MRC Scale score among all 14 patients was: 3,8 points for m. flexor pollicis longus, 4,4 points for mm. flexores digitorum and 4,4 points for m. flexor carpi radialis respectively. The median nerve mediated sensation recovered to 2,8 points on Seddon scale. Not a single patient showed effective recovery of the thenar muscles. Mean Brief MHQ score was 64,2 points – satisfactory recovery. 14 patients received effective thumb opposition within next 2 months post Bunnel’s tendon transfer. Mean Brief MHQ score increased to 78,2 points – good recovery. Surgical reconstruction of proximal median nerve injuries brings satisfying recovery of the entire muscle-complex of the anterior surface of the forearm, as well as the recovery to the median nerve mediated sensory component. Poor or no recovery of the thump opposition is majorly related to the distance between the site of the lesion and thenar’s motor-endplates. Bunnel’s tendon transfer dramatically increases functional outcomes at proximal median nerve injuries.

Acute Median Nerve Injury due to Migration of a Kirschner Wire

1998 ◽  
Vol 23 (1) ◽  
pp. 112-113 ◽  
Author(s):  
I-M. JOU ◽  
K-A. LAI
Keyword(s):  
Median Nerve ◽  
Nerve Injury ◽  
Kirschner Wire ◽  
Orthopaedic Implants ◽  
K Wires ◽  
Median Nerve Injury

Migration of orthopaedic implants such as K-wires is not unusual, but migration due to an improperly constructed brace has not been reported. This report describes such a mechanism in a case complicated by acute median nerve injury.

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