Direct Ulnar Nerve Repair Versus AIN to Motor Branch of the Ulnar Nerve End to Side Transfer in High Ulnar Nerve Injuries
Gilberto Agustin Gonzalez Trevizo, MD
Texas Tech University Health Sciences Center, El Paso, TX
Introduction/Purpose: To evaluate clinical differences between standard ulnar nerve repair and standard ulnar nerve repair with AIN transfer in the setting of proximal ulnar nerve injuries.
Hypothesis: AIN to motor branch of the ulnar nerve transfer for proximal ulnar nerve injuries will lead to improved outcomes. Inclusion criteria: All patients treated at TTUHSC/UMC from 01/01/2015 to 12/31/2016 who sustained proximal ulnar nerve injuries treated with standard repair and those patients treated with standard repair and AIN to motor branch of the ulnar nerve transfer Exclusion criteria: Patients with multiple nerve injuries in addition to ulnar nerve injury. Patients with chronic cases, >6wks, of ulnar nerve injury and late presentation. Patients with trauma requiring alteration (amputation, fusion, or tendon transfer) of any of the muscles innervated by the ulnar nerve responsible for bone and joint function distal to the site of injury.
Methods: A retrospective chart review of prospectively collected data of 30 patients in each group will be conducted, total 60 patients included. Variables to be studied include: demographics, standard surgical variables. Primary outcomes will be hand strength and function, number of patients to have recovery as well as time to recovery, and a functional outcome score. If data is unavailable through chart review patients will be contacted via telephone or a request for an office visit will be made. Results: We expect that AIN supercharge will be superior to standard repair in terms of hand function.
Discussion/Conclusion: The rate of recovery after nerve injury is 1mm per day. In proximal lesions recovery time may be prolonged. During this prolonged recovery time the muscles innervated by the damaged nerve are not receiving a stimulus to continue working and thus may atrophy or may permanently lose function. AIN supercharge is a reliable technique to sustain stimulation during nerve recovery.
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