Intrinsic Hand Muscle Reinnervation by Median-Ulnar End-to-Side Bridge Nerve Graft: Case Report

Recovery of either the motor or sensory functions has not been consistently achieved in upper extremity end-to-side neurorrhaphy; this technique was only indicated when more conventional nerve repair was not possible. In most studies, the whole median or ulnar nerve was used for end-to-side neurotization. In this report, we present 4 cases of high-median or ulnar nerve laceration in which a nerve graft was placed end-to-side between the median and ulnar motor fascicles close to the wrist. At 4 months after surgery, 3 of 4 patients began to recover active movement of the affected small muscles of the hand. EMG and nerve conduction studies confirmed that nerve conduction was through the nerve grafts. (J Hand Surg 2010;35A:446-450. Copyright (C) 2010 by the American Society for Surgery of the Hand. All rights reserved.)