Case report: Double nerve transfer of the anterior and posterior interosseous nerves to treat a high ulnar nerve defect at the elbow

Neurotization of the Superficial Sensory Branch of Ulnar Nerve by the Distal Posterior Interosseous Nerve: Cadaveric Feasibility Study

“…The absence of axons in six of the PIN samples (37.5% of cases) is a limitation of this technique. We speculate that the PIN could provide limited sensory recovery in 62.5% of cases, consistent with results reported by Delclaux et al 19 The traction necessary to pass the PIN through the interosseous membrane could have induced axonal loss; this would explain the absence of axons in the six PIN samples. Finally, it should be noted that care should be taken when operating on the elderly since diminished proprioceptive fascicle reserve within the PIN in this group of patients could result in poor corticalization and regional perception outcome.…”

“…18 In 2014, Delclaux et al described a case of double neurotization of UN via transfer of the PIN to the SSBUN, permitting grade S2 sensory recovery without donor-site morbidity at 18 months postoperatively. 19 The greatest strength of this operative technique is its negligible risk of neurological deficit for the donor site. The origin of the most distal motor branch of PIN nerve lies approximately 46.9 mm proximal to the ulnar head.…”

“…[23][24][25] The case report published by Delclaux et al does not seem representation of the expected results of this novel technique; therefore, a larger clinical study is required to establish its possible effectiveness and limitations. 19,25 Fifty-seven percent of nerve injuries involving upper extremities occur in patients aged 16 to 35 years; 1 therefore, the advanced age of our cadavers together with the anticipated diminished fascicle count rendered our sample nonrepresentative of the target population. [23][24][25] In addition, microscopic data extracted from slide review were performed by a single operator (P.L.…”

“…In 2014, Delclaux et al reported rapid and successful sensorimotor recovery (M3/S2 at 18 months follow-up) using an innovative double neurotization technique of the UN by the anterior interosseous nerve (AIN) and the posterior interosseus nerve (PIN) without theoretical consequence for the donor site. 19 However, selective neurotization techniques for the motor branch of the UN by AIN was previously supported by anatomical work. 20 The objective of our study is to validate the feasibility of sensory neurotization via anatomic and histologic analyses.…”

Sensory Neurotization of the Ulnar Nerve, Surgical Techniques and Functional Outcomes: A Review

“…The time before surgery varied from one to 252 months (the one month specific early neurotization was performed after a loss of nervous tissue at the elbow level in a 36-year-old patient, but the authors did not give any explanation about the early procedure timing). Although some of the surgeries were performed within the year following the injury, several authors described a median delay ranging from four months [ 13 ] to 67.6 months [ 14 ] ( Table 2 ).…”