Reappraisal of Clinical Deficits Following High Median Nerve Injuries

Abstract

Prognostic IV.

Delayed Transfer of the Extensor Carpi Radialis Brevis Branch of the Radial Nerve to the Anterior Interosseous Nerve for Restoration of Thumb and Index Finger Flexion: Case Report

“…1 According to traditional anatomy, a complete loss of MN motor and sensory function would be expected from such a lesion. 2 A recent critical reappraisal of clinical deficits after HMNI corroborated the findings by Boswick and Stromberg 3 in 1967 by showing that patients consistently experience absent thumb and finger index flexion, weakness of the grip and pinch, and a patchy sensory loss, mostly involving thumbindex-middle finger pulp. [2][3][4] Pronation and thumb opposition, however, are somehow relatively preserved.…”

“…2 A recent critical reappraisal of clinical deficits after HMNI corroborated the findings by Boswick and Stromberg 3 in 1967 by showing that patients consistently experience absent thumb and finger index flexion, weakness of the grip and pinch, and a patchy sensory loss, mostly involving thumbindex-middle finger pulp. [2][3][4] Pronation and thumb opposition, however, are somehow relatively preserved. 2,4 Given its rarity, 3 the ideal reconstructive strategy is yet to be determined.…”

“…[2][3][4] Pronation and thumb opposition, however, are somehow relatively preserved. 2,4 Given its rarity, 3 the ideal reconstructive strategy is yet to be determined. 4 Of note is that proximal reconstruction has consistently failed to recover the motor and sensory functions just described.…”

“…4 Of note is that proximal reconstruction has consistently failed to recover the motor and sensory functions just described. 2,3 In this regard, selective distal nerve transfers were recently introduced to improve functional outcomes after HMNI. 2,[4][5][6][7][8] Influenced by the results of Sedain et al 9 in obtaining satisfactory outcomes after delayed Oberlin transfer, we report the surgical results of a patient affected by HMNI with a partial spontaneous recovery that occurred after a gunshot wound to the arm, who was treated in a delayed fashion by transferring the radial nerve branch to the extensor carpi radialis brevis (ECRB) to the AIN.…”

Nerve transfer for sensory reconstruction of C8‐T1 dermatomes in tetraplegia

“…Overlap of the cutaneous territory is widespread which, after a spinal cord injury, ensures better preservation of sensory than motor function (Zancolli, ). We have demonstrated that sensation in the palm is supplied not only by the median nerve, but also by the superficial branch of the radial nerve and the LAC (Bertelli, Soldado, Lehn, & Ghizoni, ). Previous use of the LAC to reinnervate the dorsal branch of the ulnar nerve via an intercalated nerve graft indicates that the radial nerve can compensate for LAC harvesting (Oberlin, Teboul, Severin, & Beaulieu, ).…”