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CC BY 4.0 · Indian J Plast Surg
DOI: 10.1055/s-0044-1801805
Case Report

Augmentation of the Ulnar Motor Nerve Repair with Anterior Interosseous Nerve in High Ulnar Nerve Palsy: Our Clinical Experience

Gopika Jith
1   Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
,
Kaushik Mahadik 
1   Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
,
Santanu Suba
1   Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
,
Sanjay Kumar Giri 
1   Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
› Institutsangaben Funding None.
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Abstract

Following proximal ulnar nerve repair, there will be a delay in innervating the distally placed intrinsic muscles of the hand, which can lead to irreversible damage to the intrinsic motor end plates. Supercharging with end-to-side anterior interosseous nerve (AIN) transfer can augment the results of nerve repair by babysitting the motor end plates and thus preventing its denervation. Recently, there have been discussions regarding whether AIN, which contains only 500 axons, can augment the ulnar motor branch, which contains approximately 1,500 axons. In one of our cases, electromyogram following surgery showed activity in the first dorsal interossei and abductor digiti minimi without any signs of reinnervation in the flexor carpi ulnaris. This may support the contribution of AIN in supplying the intrinsic muscles. Considering the low morbidity of the procedure and potential improvements in muscle strength, all patients undergoing ulnar nerve repair in high ulnar nerve palsies can be counseled to undergo an end-to-side AIN transfer.

Keywords

anterior interosseous nerve - high ulnar nerve - proximal ulnar nerve palsy

Ethical Approval

This study was conducted with approval from our Institutional Review Board.


Patients' Consent

Written informed consent of the patients was obtained to publish the photographs for educational and scientific reasons and has been attached with the manuscript.




Publikationsverlauf

Artikel online veröffentlicht:
03. Februar 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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