Long-term results after primary microsurgical repair of ulnar and median nerve injuries

Wähnert, Dirk; Langer, Martin; Ochman, Sabine; Raschke, Michael J.; Schult, Marc

doi:10.1016/j.clineuro.2006.11.006

Cited by 77 publications

(65 citation statements)

References 52 publications

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“…Average final Disorders of the Arm, Shoulder and Hand (DASH) score was 22 (DASH score ranges from 0 to 100, with lower scores being better). 3 Galanakos and colleagues 53 also recently examined the prospective outcomes of 73 patients undergoing primary repair of sharp lacerations of the median and/or ulnar nerves. Patients were followed for over 3 years.…”

Section: Diagnosismentioning

confidence: 97%

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Management of Ulnar Nerve Injuries

Woo,

Bakri,

Moran

2015

The Journal of Hand Surgery

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Section: Diagnosismentioning

confidence: 97%

“…1 Unfortunately, repair of this nerve often results in incomplete recovery with functional results that are inferior to those achieved following radial nerve and median nerve repair. 3,4 This article attempts to summarize the most recent trends within the management of ulnar nerve repair.…”

mentioning

confidence: 99%

Management of Ulnar Nerve Injuries

Woo,

Bakri,

Moran

2015

The Journal of Hand Surgery

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“…The recovery of functional sensibility -often named tactile gnosis or discriminative touch, can go on for many years; however, the final result is often an incomplete recovery and long-term dysfunction for the patient. [1][2][3][4] A major determinant of functional recovery after lesions in the peripheral nervous system is the accurate regeneration of axons to their original target endorgans. Unfortunately, regenerating motor axons are often misrouted to sensory target end-organs, and sensory axons formerly innervating skin are often misrouted to muscle.…”

Section: Introductionmentioning

confidence: 99%

Differential recovery of touch thresholds and discriminative touch following nerve repair with focus on time dynamics

2014

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Introduction: The purpose of this secondary analysis of pooled data from two randomised controlled trials was to explore the differential rate of recovery of sensory and motor functions over time following repair of median or ulnar nerve. Methods: Recovery over two years following median or ulnar nerve repair at wrist level using the Rosen score was analysed in 67 patients. Results: Within the sensory domain of the Rosen score, a substantial gap was observed between recovery of touch thresholds and discriminative touch. Within the motor domain, manual muscle strength and grip strength showed a closer and more parallel recovery rate. Conclusion: The differential recovery rates in touch thresholds and discriminative touch after a peripheral nerve injury are likely due to neurobiological factors that cannot be influenced by surgical interventions. However, new knowledge about brain plasticity opens up the possibility that this differential recovery may diminish through the use of revised rehabilitation programs focused on the use of guided plasticity, and the timing of onset of sensory re-learning.

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“…Saur et al [19] described 46% of 13 ulnar nerve lesions at the distal forearm improved motor function after 3 years postoperative evaluation. In Vordemvenne et al [8] study, on average 60% recovery in ulnar nerve lesions at the wrist level was achieved.…”

Section: Injury At the Wrist Levelmentioning

confidence: 99%

Utility of the Repeatable Battery for the Assessment of Neuropsychological Status in Focal Epilepsy Patients in an Arab Cohort

AlJarrah¹

2015

JNSK

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Background: This study was embraced to examine surgical outcomes for ulnar nerve repairs, so as to help for the optimal management of these lesions. Methods:We identified 116 patients with ulnar nerve injury who were referred to our brachial plexus and peripheral nerve Injury center and underwent surgery. The demographic data about age, gender, level of injury (arm, elbow or wrist level), type of injury (penetrating or blunt), mechanisms of injury, time interval between onset of injury and surgery and functional outcomes were recorded.The functional outcomes were scored, taking into account Louisiana State University Health Sciences Center criteria, prior and then afterward the surgery. Type of repair (neurolysis, direct repair, or repair using graft), and length of graft (if any) were gathered. Results:The most widely recognized mechanism of injury was laceration in all levels. In 95 cases (81%) good functional outcome (Grade 3 or better) was achieved. The best prognosis achieved in the neurolysis (86%) and direct suture (84%), respectively. Good functional outcome was achieved in 86% of patients with nerves in continuity, and 80 % of lesions not in continuity. Overall good functional outcome was achieved in 81% (95 cases) of procedures. Conclusion:Ulnar nerves injuries are inclined to recuperate if undergo proper surgical intervention, and surgical results were for the most part better for lesions in continuity. In lesions not in continuity end-to-end direct suture showed a better prognosis than nerve graft repairs. Knowing the internal topography of ulnar nerve helps to suture more precisely which in turn may be the cause for achieving the best outcome at each level.

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Long-term results after primary microsurgical repair of ulnar and median nerve injuries

Cited by 77 publications

References 52 publications

Management of Ulnar Nerve Injuries

Management of Ulnar Nerve Injuries

Differential recovery of touch thresholds and discriminative touch following nerve repair with focus on time dynamics

Utility of the Repeatable Battery for the Assessment of Neuropsychological Status in Focal Epilepsy Patients in an Arab Cohort

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