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Functional Nerve Transfers for High Nerve Injuries of the Forearm
Fatih Zor, MD; Ismail Safaz; Umit H. Ulas; Serdar Ozturk; Selcuk Isik
Gulhane Military Medical Academy, Ankara, Turkey
Hypothesis: Repair of high nerve injuries of forearm have suboptimal results despite meticulous surgical technique. In this study, we aimed to evaluate the outcome of nerve transfer in high nerve injuries of forearm.
Method: The study is performed in Gulhane Military Medical Academy between 2009-2011. Nine patients with nerve injuries at proximal forearm level is included in the study. In 6 patients ulnar nerve was injured and the remaining 3 was suffering from both median and ulnar nerve. Nerve transfers were performed for restoration of nerve functions. The algorithm use for nerve transfers is presented in Figure 1. The functional outcome is evaluated with EMG, lateral pinch and pulp pinch strength, grip strength and Jebsen hand function test.
Results: EGM evaluation revealed a functional nerve coaptation in all patients. When compared with the preoperative measurements, lateral pinch, pulp pinch, grip strength and Jebsen hand function test results showed a marked increase in the postoperative period (Table I and II). Expecially, functional results of patients with both median and ulnar nerve injury was found to be encouraging.
Conclusion: Nerve transfers provide a new option for reconstruction of high nerve injuries of forearm. Especially, it remains the only option for patients with median and ulnar nerve injury.
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