Abstract

  Anterior interosseous to ulnar motor nerve transfer offers a viable solution in the management of high ulnar nerve injuries. Following clinical observation, we sought to determine if supercharged anterior interosseus nerve (AIN) to ulnar motor nerve transfer confers a clinically significant improvement in functional outcome as measured by the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Our objective was to track the functional outcomes compared to baseline following supercharged AIN to ulnar motor nerve transfer in patients with high ulnar nerve injuries. A case series comprising a retrospective cohort included all patients who underwent an anterior interosseous to ulnar motor nerve transfer within a one-year time interval. Functional outcomes were assessed via the preoperative to postoperative change in outcome measures including DASH scores, hand strength and active range of motion. Sixteen patients were included in the final review (81.25% male, 18.75% female, mean age 54.81 ± 16.26 years) with a mean follow-up of 2.06 ± 0.892 months. Postoperative DASH scores for all combined injury etiologies, compressive etiologies, and traumatic etiologies decreased an average of 41.99%, 29.38% and 88.23% respectively. Grip strength, 3-point pinch strength, and lateral pinch strength increased an average of 41.37%, 16.38% and 55.84% respectively. Ulnar deviation and radial deviation increased an average of 46.38% and 31.58% respectively. Our findings demonstrate that end-to-side AIN to ulnar motor nerve transfer for ulnar nerve injuries may be a powerful adjunct to traditional management of above elbow nerve injuries.

Keywords: Anterior Interosseus Nerve (AIN); Disabilities of the Arm, Shoulder, and Hand (DASH); Ulnar Motor Nerve

References

1. Sassu P., et al. “Nerve transfers of the forearm and hand: A review of current indications”. Plastic and Aesthetic Research4 (2015): 195.
2. Barbour J., et al. “Supercharged End-to-Side Anterior Interosseous to Ulnar Motor Nerve Transfer for Intrinsic Musculature Reinnervation”. The Journal of Hand Surgery10 (2012): 2150-2159.
3. Baltzer H., et al. “Comparison of Ulnar Intrinsic Function following Supercharge End-to-Side Anterior Interosseous–to–Ulnar Motor Nerve Transfer”. Plastic and Reconstructive Surgery6 (2016): 1264-1272.
4. Davidge KM and Mackinnon SE. “The Supercharge End-to-Side Anterior Interosseous to Ulnar Motor Nerve Transfer for Restoring Intrinsic Function: Clinical Experience”. The Journal of Hand Surgery10 (2013).
5. Koriem E., et al. “Comparison Between Supercharged Ulnar Nerve Repair by Anterior Interosseous Nerve Transfer and Isolated Ulnar Nerve Repair in Proximal Ulnar Nerve Injuries”. The Journal of Hand Surgery American 2 (2020): 104-110.
6. Jarvie G., et al. “Supercharge End-to-Side Anterior Interosseous Nerve to Ulnar Motor Nerve Transfer for Severe Ulnar Neuropathy: Two Cases Suggesting Recovery Secondary to Nerve Transfer”. Journal of Orthopaedic Case Reports 5 (2018): 25-28.
7. Head LK., et al. “Evaluation of intrinsic hand musculature reinnervation following supercharge end-to-side anterior interosseous to ulnar motor nerve transfer”. Plastic and Reconstructive Surgery (2020).
8. Bertelli JA. “Prior to Repair Functional Deficits in Above- and Below-Elbow Ulnar Nerve Injury”. The Journal of Hand Surgery (2020).
9. Delclaux S., et al. “Case report: Double nerve transfer of the anterior and posterior interosseous nerves to treat a high ulnar nerve defect at the elbow”. Chirurgie de la Main 5 (2014): 320-324.
10. Kapoor A., et al. “Early rehabilitation of victims of traumatic ulnar injury using tendon transfer”. Injury (2020).
11. Namazi H and Haji Vandi S. “Supinator to ulnar nerve transfer via in situ anterior interosseous nerve bridge to restore intrinsic muscle function in combined proximal median and ulnar nerve injury: a novel cadaveric study”. The Journal of Surgical Research 211 (2017): 95-99.

Citation

Citation: Dylan J Parker., et al. “Improvement of Functional Outcome Via Supercharged End-to-Side Anterior Interosseous to Ulnar Motor Nerve Transfer: A Case Series".Acta Scientific Orthopaedics 3.10 (2020): 09-15.

Copyright

Copyright: © 2020 Dylan J Parker., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.