Prognostic factors for outcome after median, ulnar, and combined median–ulnar nerve injuries: A prospective study

Hundepool, Caroline A.; Ultee, Jetske; Nijhuis, T.; Houpt, Peter; Hovius, Steven E.R.

doi:10.1016/j.bjps.2014.09.043

Cited by 53 publications

(64 citation statements)

References 35 publications

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“…11,16 Given the strong correlation between the time of RTW and grip strength and sensory recovery, this protocol is considered a good option for covering the evaluating variables mentioned above. 1,17,18 Additionally, interpretation of raw data from each assessment and the total scores expressed as quotients together can give a visual analysis of the recovery progress and distinguish the fluctuation from acceptable situation and serious tendencies allowed us to modify the dose of treatment during the rehabilitation period. 11 The mean TOW after ulnar injury was 30.7 weeks and 9.3 months in 2 studies.…”

Section: Discussionmentioning

confidence: 99%

Direct electrical stimulation on the injured ulnar nerve using acupuncture needles combined with rehabilitation accelerates nerve regeneration and functional recovery—A case report

Tang

Tai

2016

Complementary Therapies in Medicine

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Section: Discussionmentioning

confidence: 99%

Direct electrical stimulation on the injured ulnar nerve using acupuncture needles combined with rehabilitation accelerates nerve regeneration and functional recovery—A case report

Tang

Tai

2016

Complementary Therapies in Medicine

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“…Proximal median nerve injuries are associated with thenar atrophy and poor thumb function (Hundepool et al, ; Kozin et al, ). Direct median nerve repair does not ensure restoration of thumb and thenar muscles function (Kilinc et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Proximal median nerve injuries are associated with thenar atrophy and poor thumb function (Hundepool et al, 2015;Kozin et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

Distal nerve transfer for thenar palsy: A cadaveric study

et al. 2020

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Introduction Severe proximal median nerve palsies often result in irreversible thenar atrophy and thumb abduction function loss. Tendon transfer involves substantial limitations and challenges; but, distal nerve transfer may provide an alternative treatment. Our goal was to validate the anatomical suitability of two distal ulnar nerve branches for thenar muscle reanimation. Materials and Methods We assessed nerve transfer to the recurrent branch of median nerve (RMN) in 16 embalmed cadaveric hands. The ulnar motor branch to the flexor digiti minimi brevis (FDMBn) and the ulnar motor branch to the third lumbrical (3rdLn) were assessed for transfer. Coaptation success was measured by the overlap of the nerve donor with the RMN and correspondence of nerve diameters. Results The mean transferable length and width of the RMN were 20.7 ± 4.5 and 1.0 ± 0.3 mm, respectively. We identified an average of three branches in the branching anatomy from the ulnar nerve to the hypothenar muscles. The maximal transferable lengths and widths of the FDMBn and the 3rdLn were 13.8 ± 4.4 and 0.5 ± 0.1 mm and 24.1 ± 6.4 and 0.4 ± 0.1 mm, respectively. The overlap with the RMN of the FDMBn and 3rdLn was 9.0 ± 3.6 (2.0–15.3) and 17.8 ± 6.0 (4.7–27.5) mm, respectively. Conclusions This anatomical study demonstrates the feasibility of distal nerve transfers between the ulnar and median nerves in the hand for reanimation of thenar muscles. Ulnar motor donors of the BrFDMBn and 3rdLn likely represent the least morbid donors with short distances for regeneration and a single coaptation repair.

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“…In 30-40% of injury occasions, the upper extremity is included [1]. Ulnar nerve injuries can bring about paresthesia, dysesthesia, and muscle weakness in the injured hand.…”

Section: Introductionmentioning

confidence: 99%

“…Gender, age, level of education, number of harmed arteries and structures, damaged nerve, location of the injury, type of the nerve injury, post traumatic stress in 1 to 3 months after repair of the peripheral nerve injury and mechanism of injury can be the predictors of functional recuperation [1].…”

Section: Introductionmentioning

confidence: 99%

Surgical Outcome of Ulnar Nerve Lesions: Not Always Disappointing

Emamhadi¹,

Alijani²,

Ghadarjani³

2015

JNSK

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Background: This study was embraced to examine surgical outcomes for ulnar nerve repairs, so as to help for the optimal management of these lesions. Methods:We identified 116 patients with ulnar nerve injury who were referred to our brachial plexus and peripheral nerve Injury center and underwent surgery. The demographic data about age, gender, level of injury (arm, elbow or wrist level), type of injury (penetrating or blunt), mechanisms of injury, time interval between onset of injury and surgery and functional outcomes were recorded.The functional outcomes were scored, taking into account Louisiana State University Health Sciences Center criteria, prior and then afterward the surgery. Type of repair (neurolysis, direct repair, or repair using graft), and length of graft (if any) were gathered. Results:The most widely recognized mechanism of injury was laceration in all levels. In 95 cases (81%) good functional outcome (Grade 3 or better) was achieved. The best prognosis achieved in the neurolysis (86%) and direct suture (84%), respectively. Good functional outcome was achieved in 86% of patients with nerves in continuity, and 80 % of lesions not in continuity. Overall good functional outcome was achieved in 81% (95 cases) of procedures. Conclusion:Ulnar nerves injuries are inclined to recuperate if undergo proper surgical intervention, and surgical results were for the most part better for lesions in continuity. In lesions not in continuity end-to-end direct suture showed a better prognosis than nerve graft repairs. Knowing the internal topography of ulnar nerve helps to suture more precisely which in turn may be the cause for achieving the best outcome at each level.

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Prognostic factors for outcome after median, ulnar, and combined median–ulnar nerve injuries: A prospective study

Cited by 53 publications

References 35 publications

Direct electrical stimulation on the injured ulnar nerve using acupuncture needles combined with rehabilitation accelerates nerve regeneration and functional recovery—A case report

Direct electrical stimulation on the injured ulnar nerve using acupuncture needles combined with rehabilitation accelerates nerve regeneration and functional recovery—A case report

Distal nerve transfer for thenar palsy: A cadaveric study

Surgical Outcome of Ulnar Nerve Lesions: Not Always Disappointing

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