Finger sensory impairment after elbow flexion reconstruction using concomitant nerve transfer from the median and ulnar nerves

Abstract

Purpose

Single and double fascicular nerve transfer using the ulnar or median nerve is performed to restore elbow flexion following injuries to the brachial plexus or nerve root. However, little is known regarding the postoperative changes involved in the sensory alteration of the hand after a single and double fascicular nerve transfer. We evaluated the sensory alteration of the hand in patients who underwent single and double fascicular nerve transfer for two years.

Methods

A total of five patients that underwent single or double fascicular nerve transfer participated in this study. The injury mechanism was avulsion (n = 2), stretching (n = 1), open injury (n = 1), and compression (n = 1). The touch sensation of the index and the little fingers before surgery at 6 months, 1 year, and 2 years after nerve transfer was evaluated using the Semmes-Weinstein monofilaments test (SWM-t). Muscle strength of the elbow flexion and the wrist flexion was evaluated.

Results

The touch sensation of the index finger at 24 months was equal to the preoperative evaluation. On the other hand, the touch sensation of the little finger at 24 months slightly improved compared to what it had been at the preoperative evaluation. Moreover, the median of the SWM-t score in the index and little finger at 24 months after surgery was beyond 3.61 that mean diminished light touch level.

Conclusions

The results of this study indicate that the touch sensory deficit of the index and little fingers persist for up to 2 years after nerve transfer.

Keywords:

• Brachial plexus injury
• sensory
• nerve transfer

Acknowledgements

These data collection were performed by members of the Rehabilitation Unit, Kyoto University Hospital. The sponsor had no role in the design or conduct of this research.

Disclosure statement

The authors report no conflicts of interest. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as consultancies; employment; advocacy groups; grants; fees and honoraria; patents; royalties; stock or share ownership), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Data availability statement

The datasets generated and analysed during this study are available from the corresponding author on reasonable request.

Additional information

Funding

This study was supported by internal funds of the Rehabilitation Unit, Kyoto University Hospital.