The role of ulnar nerve transposition in ulnar nerve repair: a cadaver study

The Journal of Hand Surgery
R A AbramsR L Lieber

Abstract

Ulnar nerve transposition at the elbow is recommended to diminish nerve gaps during neurorrhaphy. We undertook a cadaver study to determine the gap distance that can be overcome by subcutaneous transposition at the elbow, evaluating lacerations 2.0 cm distal to the medial epicondyle and 2.0 cm proximal to the wrist crease. With a 100-g load on each nerve stump, gaps that could be overcome were measured before and after transposition in different elbow and wrist positions. For the distal forearm lacerations, wrist position significantly affected nerve gap, while transposition and elbow position did not. Nerve gap was significantly reduced by approximately 11 mm with wrist flexion from 0 degrees to 45 degrees. For proximal forearm lacerations, gap distance was significantly affected by transposition and was dependent to a greater extent on the interaction between transposition and elbow position, with wrist position having no effect. A clinically relevant scenario for the proximal laceration compared the pretransposition gap with the elbow and wrist at neutral with the posttransposition gap with the elbow and wrist flexed. Posttransposition gap reduction, with elbow and wrist flexion at 45 degrees, was approximately 9 mm and was ...Continue Reading

References

Oct 1, 1979·Plastic and Reconstructive Surgery·Y Miyamoto
Jul 1, 1992·The Journal of Hand Surgery·W L ClarkA F Tencer
Sep 1, 1990·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·B L RydevikS R Garfin
Mar 1, 1997·The Journal of Hand Surgery·H E TadjalliJ Abrams

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Citations

Oct 11, 2014·The Journal of Hand Surgery·Imran K ChoudhryZhongyu Li
Sep 4, 2007·Hand Clinics·H James PfaeffleThomas E Trumble
Dec 3, 2014·The Journal of Hand Surgery·Alice WooSteven L Moran
Jan 22, 2009·AJR. American Journal of Roentgenology·Hatice Tuba SanalDonald L Resnick

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