Electrodiagnostic Predictors of Outcomes After In Situ Decompression of the Ulnar Nerve

Florczynski, Matthew; Kong, Lingxuan; Burns, Patricia B.; Wang, Lu; Chung, Kevin C.

doi:10.1016/j.jhsa.2022.10.008

Cited by 6 publications

(3 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A volar skin defect on the fingertip is one of the most common hand injuries. Therefore, the optimal reconstruction of volar fingertip defects requires padding, maximum tactile gnosis coverage, adequate finger length, and satisfactory aesthetic contour [ 15 ]. Typically, there is agreement that replantation is the optimal treatment for fingertip loss restoration.…”

Section: Discussionmentioning

confidence: 99%

“…The aesthetics of both the reconstructed and donor sites were evaluated using the Vancouver Scar Scale (VSS) [ 14 ], which assesses pigmentation, vascularity, pliability, and height. The static two-point discrimination (2-PD) [ 15 ] of the finger pulp was employed as a measure of tactile agnosia, indicating finger nerve recovery. All tests were performed by an independent senior hand surgeon.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Comparison treatment of medium-sized volar fingertips defects with modified triangular neurovascular unilateral advancement flap versus digital artery dorsal perforator flap

Zhu,

Zhou,

Zhang

et al. 2024

J Orthop Surg Res

View full text Add to dashboard Cite

Purpose The reconstruction of medium-sized soft tissue defects of the fingertip remains a challenge for hand surgeons. The aim of this study was to compare the outcomes of modified triangular neurovascular unilateral advancement flap and digital artery dorsal perforator flap in the treatment of this injury. Methods From May 2018 to May 2022, 70 patients with medium-sized volar soft tissue defects were enrolled. The patients were divided into two groups based on the flap type: modified triangular neurovascular unilateral advancement flap (Group A) and digital artery dorsal perforator flap (Group B). The debridement times, defect size, operation time, and flap survival rate were recorded. At follow-up, hand function, aesthetics, and complications were evaluated. Function was evaluated using the TAM score. The aesthetics of the reconstructed and donor sites were assessed using the vancouver scar scale (VSS). The static two-point discrimination of the finger pulp served as a measure of tactile agnosia. Results A total of 10 patients were lost to follow-up for various reasons, resulting in 30 cases remaining in each group. The general information of the two groups showed no significant differences in age, sex, injury side, cause of injury, time from injury to surgery, and operation time (P > 0.05). Additionally, the debridement times and size of the defect were similar between the groups (P > 0.05). However, the operation time was significantly shorter in Group A compared to Group B (P = 0.001). With regard to complications, there was no significant difference between them. At one-month follow-up, TAM scores indicated that Group B performed significantly better than Group A. However, at the final follow-up period, there was no significant difference in TAM scores between the two groups. When considering the VSS, significant differences were observed between the two groups in both the reconstructed site and donor site. Conclusion Both flaps can effectively repair medium-sized fingertip defects. Furthermore, the modified triangular neurovascular unilateral advancement flap offers anatomical reconstruction possibilities, ensuring satisfactory sensation and cosmetic contour.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Comparison treatment of medium-sized volar fingertips defects with modified triangular neurovascular unilateral advancement flap versus digital artery dorsal perforator flap

Zhu,

Zhou,

Zhang

et al. 2024

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…The role of electrodiagnosis has been questioned because no prognostic role has been established and the correlation between symptoms and electrophysiological findings is weak [28][29][30][31] . On the other hand, some argue that the use of electromyography (EMG) and nerve conduction studies can help to support the diagnosis, to locate the nerve affection and to grade the nerve damage 25,32 .…”

Section: Electrophysiology Testsmentioning

confidence: 99%

Surgery for ulnar nerve compression at the elbow : Focusing on factors influencing outcome

Giöstad

2023

Linköping University Medical Dissertations

View full text Add to dashboard Cite

Ulnar nerve compression at the elbow (UNE) is a common peripheral nerve compression disorder in the upper limb. The literature regarding surgical outcome is inconclusive.This thesis aims to highlight various aspects of real-life settings for patients with UNE and to increase the understanding of underlying factors influencing the outcome of surgery.Patients undergoing surgery for UNE at a tertiary referral hospital were retrospectively evaluated (Linköping cohort; n=202). Comorbidity was extensive.Patients treated with simple decompression (SD) had a lower rate of complications than those with transposition surgery. Emerging neurogenic pain was the most common complication, with a two-fold risk for smokers. Scores from the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire revealed no differences between the surgical groups. Satisfaction with surgery was relatively low (53%), however only 8% stated that they would not go through the same surgical procedure again.Images from magnetic resonance imaging (MRI), performed in conjunction with surgery (Linköping cohort; 62 patients), were re-evaluated by a neuroradiologist.Spinal nerve root pathology contributing to the ulnar nerve (C8-Th1) was rare (1/62 patients), however, nerve root affections at other levels were common (26/62). No relation between cervical pathology and patient-reported outcome was seen.The Linköping cohort was combined with two cohorts from Region Skåne to evaluate time before return to work (RTW) after surgery for UNE (n=635 in total). RTW within 6 weeks was more common among older, SD and non-manual workers.Those who were unemployed were on sick leave longer than the rest of the population.Transposition of the ulnar nerve was the only predictor for prolonged RTW in the regression model. Paper V Experiences of living with chronic pain in conjunction with surgery for ulnar nerve compression at the elbowa qualitative studyAim: To explore experiences and consequences of living with chronic pain in conjunction with surgery for UNE.Methods: Purposeful sampling including patients with experience of chronic pain (lasting >3 months) in conjunction with UNE surgery/surgeries. In-depth interviews were carried out and transcribed. The transcripts were read and re-read and subjected to content analysis independently by two people.Results and conclusions: Chronic pain in conjunction with surgery for UNE affects most aspects of daily life and contributes to a heavy burden for the individual. The results clarify the need for a biopsychosocial approach among healthcare personnel when treating patients with UNE.

show abstract

Understanding risk factors for revision surgery after cubital tunnel release: Analysis of patient selection, surgeon, and clinical factors

Campbell,

Cohen,

Alfonsi

et al. 2024

Journal of Hand and Microsurgery

View full text Add to dashboard Cite

Electrodiagnostic Predictors of Outcomes After In Situ Decompression of the Ulnar Nerve

Cited by 6 publications

References 47 publications

Comparison treatment of medium-sized volar fingertips defects with modified triangular neurovascular unilateral advancement flap versus digital artery dorsal perforator flap

Comparison treatment of medium-sized volar fingertips defects with modified triangular neurovascular unilateral advancement flap versus digital artery dorsal perforator flap

Surgery for ulnar nerve compression at the elbow : Focusing on factors influencing outcome

Understanding risk factors for revision surgery after cubital tunnel release: Analysis of patient selection, surgeon, and clinical factors

Contact Info

Product

Resources

About