ArticlePlastic and reconstructive surgery. Global open2021
Immediate Tendon Transfer with Nerve Repair in Low Combined Ulnar and Median Nerve Injury.
Article in Plastic and reconstructive surgery. Global open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCombined median-ulnar nerve injury at the level of distal forearm (below the musculotendinous junction) causes a detrimental effect on hand functions, which have a great impact on patients' hands as well as a financial burden. Many previous authors advocated early or immediate tendon transfer in solitary median or ulnar nerve injuries.
methodsThis study included 20 patients with combined distal ulnar-median nerve injury, who were divided into 2 groups. Group I (control) included 10 patients who underwent primary (group fascicular) repair of both nerves only. Group II (study) included 10 patients underwent primary (group fascicular) repair with immediate tendon transfer simultaneously: opponenplasty using extensor indicies and adductoplasty extensor carpi radialis brevis with appropriate splinting, postoperative rehabilitation, and biofeedback facilities.
resultsTwenty patients (age: 18-38 years) were affected. The response of median and ulnar nerves showed invariable results in both groups, whilst the hand grip, hand pinch, and opposition showed marked improvements in group II. Moreover, inter-phalangeal and metacarpophalangeal joints of thumb showed no deformities in group II in comparison with high level of deformities in group I, owing to early regain of thumb movements.
conclusionsImmediate (during neurorrhaphy) tendon transfer may offer additional merits over nerve repair only for distal combined ulnar and median injury, as it offers scarless field, no adhesion, and no joint edema, leading to very early return to normal hand functions with a consequent decrease of thumb deformities, better hand grip, and key pinch.
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