Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. Examination of patients with distal ulnar compressive neuropathy requires a systematic approach to eliminate proximal issues from the diagnosis. Through a proximal to distal approach by examining the hand for motor/sensory and extrinsic/intrinsic function […]
Failed surgical management of cubital tunnel syndrome may warrant a revision ulnar nerve transposition. Revision surgery is associated with increased technical difficulty depending on the primary procedure. The senior author’s preferred technique for management of cubital tunnel syndrome is a transmuscular ulnar nerve transposition. The technique for revision surgery incorporates methods towards a transmuscular transposition. […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation discusses cubital tunnel syndrome (CTS) and ulnar neuropathy in the context of compression neuropathies. In particular, this presentation details several topics that includes (1) controversy of management for CTS, (2) patient evaluation, […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. In this presentation, we discuss nerve transfers and reconstructive strategies for managing ulnar nerve injuries. The anterior interosseous to ulnar motor nerve transfer is the procedure, where we utilize end-to-end repair for complete nerve […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation is an introduction to nerve transfers and details the indications for performing these procedures. Experimental studies are discussed in respect to nerve injury and recovery and the window for reinnervation. The classification […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation describes the premise for the supercharge end-to-side nerve transfer and its clinical utility for incomplete injuries involving the ulnar nerve. Specifically, this presentation discuss the indications for this procedures, the research involved […]
Injury to the ulnar nerve results in clawing of the hand due to lost of ulnar intrinsic hand muscles, lost of ulnar-innervated wrist/finger flexion, and numbness/pain within the ulnar nerve territory of the hand. To prevent clawing and reconstruct the ulnar intrinsic hand muscles, the anterior interosseous to ulnar motor nerve transfer is an available […]
Sensory nerve transfers are an available option for restoring sensation to critical deinnervated territories. Multiple strategies exist for restoring sensation, which include end-to-end nerve transfers for critical territories and end-to-side nerve transfers for non-critical territories. For sensory deficits in the ulnar nerve, the 3rd webspace fascicle from the median nerve can be utilized as a […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation is the second part of the topic on Acute Nerve Injury and Repair given for the 2012 Comprehensive Review of Neurosurgery video lectures. Specifically, this presentation discusses reconstructive strategies for general topics […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. Transmuscular ulnar nerve transposition is our method for surgical management of cubital tunnel syndrome. Previously known as ”submuscular”, we have transitioned to ”transmuscular” as this term accurately describes this transposition as through the flexor […]
The supercharge nerve transfer is a procedure that coapts the distal end of a donor nerve to the side of the recipient nerve. Nerve regeneration is facilitated from donor to recipient through a perineurial window to enhance regeneration from the proximal regenerating nerve. This procedure can be used in cases of 2nd/3rd degree nerve injuries […]
For distal sensory ulnar nerve injuries in the hand, there is an alternative approach in restoration of critical ulnar nerve sensation. In this case, the patient had a gunshot wound and required amputation of the small finger. As result, the ulnar aspect of the ring finger became the critical target for sensory reinnervation. In addition, […]
A submuscular ulnar nerve transposition is performed to decompress the ulnar nerve in the cubital tunnel at the elbow. The medial antebrachial cutaneous nerve is identified and protected. Proximally, the medial intermuscular septum is resected. A step-lengthening of the fascia of the flexor-pronator muscles is performed. The ulnar nerve is placed in a transmuscular location. […]
The double fascicular transfer (DFT) includes two nerve transfers: (1) median fascicle to biceps branch and (2) ulnar fascicle to brachialis branch. The median fascicle contains nerve fibers that innervate flexor digitorum superficialis / flexor carpi radialis. The ulnar fascicle contains nerve fibers that innervate flexor carpi ulnaris. The donor fascicles can be used for […]
The donor anterior interosseous nerve (AIN) is transferred to the side of the recipient ulnar motor fascicular group within the distal forearm to preserve ulnar nerve motor intrinsics. Guyon’s canal release is a required part and is completed prior to this procedure. Specific to this case, a revision ulnar nerve transposition was completed proximally. This […]