Vol. 8, Issue 4, Part A (2024)
Functional outcomes following anterior interosseous nerve transfer in cases of ulnar nerve injury
Author(s):
Abdel-Nasser Ahmad Saleh, Mohamed Abobakr Atia Eldayasty, Esayed Said Esayed Abdou and Aly Aly Ibrahim Attia Alaswad
Abstract:
Background: Sensory and motor hand deficits are a consequence of ulnar nerve injuries. An operation in scarred areas can be avoided due to the fact that nerve transfer is not contingent upon the location of the injury. Additionally, with only one nerve transfer, it can regenerate whole muscle groups. In the presence of an ulnar nerve lesion, the objective of this study was to determine the potential functional effects of connecting the anterior interosseous space to the deep motor branch of the ulnar nerve.
Methods: The interventional study was performed on ten patients, seven of whom were male and three of whom were female, the range of age was 18 to 42 years. The distal neurotization was performed on all patients, who had sustained proximal high ulnar nerve injury. At the time of the trauma, all patients had undergone a single ulnar nerve repair. All patients were monitored at three-month, six-month, and eight-month intervals. The standard Medical Research Council classification was slightly modified to estimate the intrinsic hand muscles strength. Birch's grading was employed to evaluate the ulnar nerve recovery.
Results: After six months, motor outcomes were as follows: in the 3rd palmar interosseous, 20.0% demonstrated good grading, while 80.0% exhibited poor or suboptimal grading; Seventy percent received good grading in the second palmar interosseous, thirty percent showed suboptimal or bad grading; in the first palmar interosseous, thirty percent received very good grading, fifty percent got acceptable grading, and twenty percent showed poor or suboptimal grading; in the dorsal interossei, Forty percent received high or very good grades, while twenty percent received suboptimal grading; and in the adductor pollicis, 30.0% achieved good grading, while 70.0% received very good grading. Concerning functional outcomes after six months: in grip enhancement, 70.0% exhibited significant improvement while 30.0% demonstrated moderate improvement; in pinch enhancement, 40.0% showed moderate improvement and 60.0% displayed significant improvement; in clawing enhancement, just 20.0% indicated improvement. Excellent grading was markedly superior among those who adhered to physical treatment (87.5%) in comparison with non-compliers (0.0%) (P= 0.016).
Conclusion: The operation is straightforward, has low donor-site morbidity, and serves as an effective choice for restoring functions of ulnar nerve in instances with lesions of high ulnar nerve.
Pages: 01-08 | 251 Views 63 Downloads
How to cite this article:
Abdel-Nasser Ahmad Saleh, Mohamed Abobakr Atia Eldayasty, Esayed Said Esayed Abdou and Aly Aly Ibrahim Attia Alaswad. Functional outcomes following anterior interosseous nerve transfer in cases of ulnar nerve injury. Nat. J. Clin. Orthop. 2024;8(4):01-08. DOI: https://doi.org/10.33545/orthor.2024.v8.i4a.454