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Evaluation of the functional recovery of intrinsic muscle after nerve transfer in ulnar nerve lesions
Soo-Min Cha, MD
Chungnam National University School of Medicine, Daejeon, Korea, Republic of (South)

Purpose: Even though “supercharge” end-to-side (SETS) nerve transfer for lesions of the proximal ulnar nerve has been recognized as a novel option, improvements in motor function after surgery have not been properly evaluated. Thus, we suggested a modified method for quantitative evaluation of improvements in hand intrinsic power.

Methods: To measure intrinsic muscle power, we screened 216 patients with lesions of the high ulnar nerve who visited the outpatient department from 2012 to 2020. Of these patients, 101 who met our inclusion/exclusion criteria were evaluated just before surgery. We used a newly designed method for the measurement of finger abduction (“2nd-abd”), adduction (“5th-add”), and ring and little finger flexion strength (“4,5 grip”) and analyzed the correlations of these measurements with already well-known pinch strength data.

Results: Among one hundred one patients, the male to female ratio was 86:15, and the ratio of “lesion on dominant arm” to “lesion on nondominant arm” was 68:33. All strength measurements were analyzed as a % (ratio of strength; affected side to contralateral normal side). In a Pearson correlation analysis, the strength ratios of “4,5 grip”, “2nd-abd”, and “5th-add”, but not “5 fingers grip (total grip)”, were significantly positively correlated with key and oppositional pinch strength, respectively (all, p < 0.001). Additionally, linear regression analysis showed identical results for each strength correlation with key/oppositional pinch, except for “5 fingers grip (total grip)” (all, p < 0.001).

Conclusions: SETS can be used as the gold standard option rather than other surgical solutions for lesions of the proximal ulnar nerve. The measurement method we propose would be feasible for a specific assessment of intrinsic muscle strength, which would be improved after the procedure.

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