Open AccessMeaningful power grip recovery after salvage reconstruction of a median nerve avulsion injury with a pedicled vascularized ulnar nerve
Author(s) -
Aaron C. Van Slyke,
Leigh A. Jansen,
Sally Hynes,
Jane Hicks,
Sean Bristol,
Nicholas Carr
Publication year - 2015
Publication title -
plastic surgery
Language(s) - English
Resource type - Journals
eISSN - 2292-5511
pISSN - 2292-5503
DOI - 10.4172/plastic-surgery.1000940
Subject(s) - medicine , ulnar nerve , surgery , median nerve , cubital tunnel , anatomy , grip strength , nerve injury , elbow , cubital tunnel syndrome
In cases of median nerve injury alongside an unsalvageable ulnar nerve, a vascularized ulnar nerve graft to reconstruct the median nerve is a viable option. While restoration of median nerve sensation is consistently reported, recovery of significant motor function is less frequently observed. The authors report a case involving a previously healthy man who sustained upper arm segmental median and ulnar nerve injuries and, after failure of sural nerve grafts, was treated with a pedicled vascularized ulnar nerve graft to restore median nerve function. Long-term follow-up showed near full fist, with 12 kg of grip strength, key pinch with 1.5 kg of strength and protective sensation in the median nerve distribution. The present case demonstrates that pedicled ulnar vascularized nerve grafts can provide significant improvements to median nerve sensory and motor function in a heavily scarred environment.