Excision and Inter-Positional Sural Nerve Graft for Post-Traumatic Non-Conducting Ulnar Nerve Neuroma | ||||
The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
Article 2, Volume 44, Issue 3, July 2020, Page 401-406 PDF (11.85 MB) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ejprs.2020.122293 | ||||
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Authors | ||||
Amr Mohamed Khater* 1; Reda Abdallah Younis1; Nehal Tharwat Mohamed El Sayed2 | ||||
1The Department of Plastic Surgery, Faculty of Medicine, Mansoura University | ||||
2The Department of Radiodiagnosis, Faculty of Medicine, Mansoura University | ||||
Abstract | ||||
Introduction: Ulnar nerve injuries around the wrist result in paralysis of intrinsic muscles and sensory loss of little finger and ulnar half of ring finger. Formation of traumatic neuroma of the ulnar nerve adds pain at the site of nerve repairs. Patients and Methods: 10 patients were included in this study. Clinical, radiological and electrophysiological assessment indicate surgery in these patients where neuroma was excised, identification of sensory and motor fascicles of the ulnar nerve was done and cable nerve grafts were used to bridge the nerve defects. Assessment of the outcome was done in patients who finished follow-up for at least one year. Results: Pain at the site of neuroma disappeared after surgery. All patients were followed-up and 6 patients needed tendon transfer after one year. Sensory recovery was achieved after one year. Trophic changes and cold intolerance was improved. Discussion: Primary repair of ulnar nerve injuries is the gold standard treatment for such injuries. Claw hand, weakness of the hand grip and abduction deformities are the main motor defects which can be corrected by tendon transfers. However, sensory defects and cold intolerance affected the outcome of surgery. When the diagnosis of non-conducting neuroma is made, neuroma resection and reconstruction improve the clinical outcome. Conclusion: The unfavorable outcomes of ulnar nerve injuries can be improved by resection of neuroma in continuity and nerve grafting. Multidisciplinary team is needed to achieve the best clinical outcomes. | ||||
Keywords | ||||
Ulnar nerve; Fascicular repair; Neuroma; Wallerian degeneration | ||||
References | ||||
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