Motor branches of the ulnar nerve to the forearm: an anatomical study and guidelines for selective neurectomy

Paulos, Renata Gregorio; Leclercq, Caroline

doi:10.1007/s00276-015-1448-1

Cited by 24 publications

(16 citation statements)

References 27 publications

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“…Similar results were obtained in our study. Paulos et al reported that the ulnar nerve distal to the elbow has two to five muscular branches to the flexor carpi ulnaris and one to two muscular branches to the flexor digitorum profundus [21]. The ulnar nerve may be strongly anchored to the forearm flexors by multiple branches.…”

Section: Discussionmentioning

confidence: 99%

A Cadaveric Study of Ulnar Nerve Movement and Strain around the Elbow Joint

et al. 2021

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There is a lack of data on how ulnar nerve strain varies according to the location around the elbow joint. Therefore, we measured the longitudinal movement of the ulnar nerve around the elbow joint. Four fresh-frozen cadaveric upper extremities were used. A linear displacement sensor was attached to the ulnar nerve at eight measurement points at 20-mm intervals. At each point, the longitudinal movement of the ulnar nerve was measured during elbow flexion. We calculated the strain on the ulnar nerve based on the change in movement between neighboring points. Ulnar nerve movement with elbow flexion had a maximum value (mean, 10.5 mm; p < 0.001) at 2 cm proximal to the medial epicondyle. In the site distal to the medial epicondyle, the movement was small and demonstrated no significant difference between points (p = 0.1). The change in strain between mild flexion (0–60°) and deep flexion (60–120°) significantly differed at 2–4 cm and 6–8 cm proximal to the medial epicondyle (15% versus 3%, p < 0.01; 5% versus 9%, p < 0.05, respectively). The longitudinal movement of the ulnar nerve during elbow flexion occurred mainly at the site proximal to the medial epicondyle and became smaller away from the medial epicondyle.

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Section: Discussionmentioning

confidence: 99%

A Cadaveric Study of Ulnar Nerve Movement and Strain around the Elbow Joint

et al. 2021

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“…Nerve bundles are consisted of multiple nerve fibers innervating different muscles. Previous studies showed that distribution of nerve fibers in some nerve bundles may be topographically arranged according to the targets before nerve branches 51–53 . Detailed microanatomical studies revealed the fascicular topography of the brachial plexus 16,54 , indicating some level of somatotopic organization in C7.…”

Section: Discussionmentioning

confidence: 99%

A shape-memory and spiral light-emitting device for precise multisite stimulation of nerve bundles

Zheng

Zhang

et al. 2019

Nat Commun

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We previously demonstrated that for long-term spastic limb paralysis, transferring the seventh cervical nerve (C7) from the nonparalyzed side to the paralyzed side results in increase of 17.7 in Fugl-Meyer score. One strategy for further improvement in voluntary arm movement is selective activation of five target muscles innervated by C7 during recovery process. In this study, we develop an implantable multisite optogenetic stimulation device (MOSD) based on shape-memory polymer. Two-site stimulation of sciatic nerve bundles by MOSD induces precise extension or flexion movements of the ankle joint, while eight-site stimulation of C7 nerve bundles induce selective limb movement. Long-term implant of MOSD to mice with severed and anastomosed C7 nerve is proven to be both safe and effective. Our work opens up the possibility for multisite nerve bundle stimulation to induce highly-selective activations of limb muscles, which could inspire further applications in neurosurgery and neuroscience research.

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“…21,22,23 Stoffel's publication highlighted the importance of detailed knowledge of the anatomy and the variations of nerve supply. 13 Further cadaveric detailed anatomic studies of the terminal branches of the musculocutaneous 24 the median nerve 25 and the ulnar nerve 26 in cadavers has helped considerably in optimising surgical techniques and incisions when selective neurectomy is used to treat hypertonia in a functional Upper Limb. Selective Peripheral Neurectomy has been used for the treatment of neurectomy in various levels of the Upper Limb with a variety of results.…”

Section: Mini Reviewmentioning

confidence: 99%

The rationale of operative treatment for spasticity of the upper limb

Mikalef¹,

Power²

2018

MOJOR

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| http://medcraveonline.com modalities. 2 Any non-operative treatment modality is considered to be reversible, 3 so it gives the treating healthcare professional the advantage to stop or modify it if the result is suboptimal.Operative treatment of Spasticity is indicated when the patient's function is impaired, when it causes significant pain to the patient, when it makes caring for the patient troublesome, or when it may lead to irreversible deformities of the skeletal system. 4 It is understandable that operative treatment is irreversible and the results of this treatment are permanent for the patient. 3 Operative treatment is expected to decrease, eliminate or redirect muscle forces, mobilize stiff joints, restore balance to joints or stabilize joints, but it is not expected to restore volitional control to muscles or increase muscle force generation. 5 Patients with Spasticity that involves the Upper Limb can be either functional or non-functional. 6 Thorough and detailed preoperative assessment is essential through a multidisciplinary setting where all health professionals who are treating the patient are involved. 6,7 In the functional patient the aim of any treatment modality is usually to improve function by restoring the balance between agonists and antagonists. In the non-functional patient the treatment usually aims to improve hygiene, sometimes improve pain, and to facilitate dressing and nursing. An important part of the decision making is preop assessment with the use of nerve blocks or Botulinum toxin. Botulinum toxin and nerve blocks can give a result which is very similar to the result after surgery. This can give the patient, the carers and the members of his/her family the opportunity to see the condition of the limb after surgery. 8

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Motor branches of the ulnar nerve to the forearm: an anatomical study and guidelines for selective neurectomy

Cited by 24 publications

References 27 publications

A Cadaveric Study of Ulnar Nerve Movement and Strain around the Elbow Joint

A Cadaveric Study of Ulnar Nerve Movement and Strain around the Elbow Joint

A shape-memory and spiral light-emitting device for precise multisite stimulation of nerve bundles

The rationale of operative treatment for spasticity of the upper limb

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