Anterior Interosseous Nerve to Ulnar Nerve Transfer: A Systematic Review

Thakkar, Mehul; Rose, Anna; Engelman, Kelsey; Bednarz, Bartlomiej

doi:10.1016/j.jpra.2022.02.007

Cited by 9 publications

(6 citation statements)

References 32 publications

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“…At a final 2 year follow up, they found that patients in the SETS treatment group had significantly better pinch strength and compound motor action potentials (CMAP) on electrodiagnostic studies ( 62 ). A systematic review of 16 studies by Thakkar et al also supported improved outcomes in SETS AIN to distal ulnar nerve transfers compared to traditional techniques ( 15 ).…”

Section: Indications and Timing For Nerve Transfer Surgerymentioning

confidence: 93%

Assessment, patient selection, and rehabilitation of nerve transfers

Bateman,

Larocerie-Salgado,

Ross

et al. 2023

Front. Rehabil. Sci.

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Peripheral nerve injuries are common and can have a devastating effect on physical, psychological, and socioeconomic wellbeing. Peripheral nerve transfers have become the standard of care for many types of peripheral nerve injury due to their superior outcomes relative to conventional techniques. As the indications for, and use of, nerve transfers expand, the importance of pre-operative assessment and post-operative optimization increases. There are two principal advantages of nerve transfers: (1) their ability to shorten the time to reinnervation of muscles undergoing denervation because of peripheral nerve injury; and (2) their specificity in ensuring proximal motor and sensory axons are directed towards appropriate motor and sensory targets. Compared to conventional nerve grafting, nerve transfers offer opportunities to reinnervate muscles affected by cervical spinal cord injury and to augment natural reinnervation potential for very proximal injuries. This article provides a narrative review of the current scientific knowledge and clinical understanding of nerve transfers including peripheral nerve injury assessment and pre- and post-operative electrodiagnostic testing, adjuvant therapies, and post-operative rehabilitation for optimizing nerve transfer outcomes.

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Section: Indications and Timing For Nerve Transfer Surgerymentioning

confidence: 93%

Assessment, patient selection, and rehabilitation of nerve transfers

Bateman,

Larocerie-Salgado,

Ross

et al. 2023

Front. Rehabil. Sci.

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“…28,62 The published studies also reflect a trend to consider RETS transfers for less complete injuries. In the meta-analysis by Thakkar et al, 14 the mean preoperative BMRC grade of intrinsic muscles in ETE and RETS groups were 0 and 1.3, respectively. However, in one clinical study, the addition of a RETS transfer improved the return of intrinsic function significantly in ulnar nerve transections (84 vs 14%), but not for in-continuity lesions (67% vs 67%), 39 yet this study compared results from 2 very different populations, undermining its conclusions.…”

Section: Patient Selectionmentioning

confidence: 94%

“…In a meta-analysis of 48 AIN to ulnar nerve ETE transfers (mean follow-up 24.5 months), 100% recovered intrinsic muscle strength to British Medical Research Council (BMRC) ≥M1 (average recovery time 3.6 months); 85% recovered to BMRC ≥M3 (only 20% achieved M3 with conventional surgery in 1 study 7 ); the mean improvement in BMRC was 3.1. 14…”

Section: Anterior Interosseous Nerve As a Donormentioning

confidence: 99%

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Reverse End-to-Side Transfer to Ulnar Motor Nerve: Evidence From Preclinical and Clinical Studies

Pathiyil

Alzahrani²,

Midha³

2023

Neurosurgery

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The disappointing outcomes of conventional nerve repair or grafting procedures for proximal ulnar nerve injuries have led the scientific community to search for better alternatives. The pronator quadratus branch of the anterior interosseous nerve has been transferred to the distal ulnar motor branch in a reverse end-to-side fashion with encouraging results. This transfer is now becoming commonly used as an adjunct to cubital tunnel decompression in patients with compressive ulnar neuropathy, underscoring the need for this knowledge transfer to the neurosurgical community. However, the mechanism of recovery after these transfers is not understood completely. We have reviewed the existing preclinical and clinical literature relevant to this transfer to summarize the current level of understanding of the underlying mechanisms, define the indications for performing this transfer in the clinic, and identify the complications and best practices with respect to the operative technique. We have also attempted to identify the major deficiencies in our current level of understanding of the recovery process to propose directions for future research.

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“…This is Dr. Rajiv Midha and I am pleased to present a case of a distal anterior interosseous nerve (AIN) transfer 1 – 4 in this patient with severe traumatic ulnar neuropathy at the elbow.…”

Section: Transcriptmentioning

confidence: 95%

Distal anterior interosseous nerve to ulnar nerve motor branch reverse end-to-side transfer in a case of severe ulnar neuropathy

Pathiyil¹,

Elzinga

Umansky³

et al. 2023

Neurosurgical Focus: Video

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Reverse end-to-side (RETS) distal transfer is gaining popularity in cases of proximal nerve damage with the nerve in continuity, allowing the nerve to potentially retain its ability to regenerate and recover. While preserving the original axon pool, RETS could provide an additional pool of motor axons and/or possibly "babysit" the muscle endplates and distal denervated nerve Schwann cells until reinnervation from the original pool occurs. The authors present a video demonstrating anterior subcutaneous transposition of the ulnar nerve at the elbow coupled with a distal anterior interosseous nerve to ulnar nerve RETS in a case of severe posttraumatic ulnar neuropathy at the elbow. The video can be found here: https://stream.cadmore.media/r10.3171/2022.9.FOCVID2282

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Anterior Interosseous Nerve to Ulnar Nerve Transfer: A Systematic Review

Cited by 9 publications

References 32 publications

Assessment, patient selection, and rehabilitation of nerve transfers

Assessment, patient selection, and rehabilitation of nerve transfers

Reverse End-to-Side Transfer to Ulnar Motor Nerve: Evidence From Preclinical and Clinical Studies

Distal anterior interosseous nerve to ulnar nerve motor branch reverse end-to-side transfer in a case of severe ulnar neuropathy

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