Intrinsic Function

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Susan E Mackinnon - One of the best experts on this subject based on the ideXlab platform.

  • supercharge end to side anterior interosseous to ulnar motor nerve transfer restores Intrinsic Function in cubital tunnel syndrome
    Plastic and Reconstructive Surgery, 2020
    Co-Authors: Jana Dengler, Andrew Yee, Lorna C. Kahn, Utku Can Dolen, Jennifer Megan M Patterson, Kristen M Davidge, Susan E Mackinnon
    Abstract:

    Background The supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer offers a viable option to enhance recovery of Intrinsic Function following ulnar nerve injury. However, in the setting of chronic ulnar nerve compression where the timing of onset of axonal loss is unclear, there is a deficit in the literature on outcomes after supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer. Methods A retrospective study of patients who underwent supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer for severe cubital tunnel syndrome over a 5-year period was performed. The primary outcomes were improvement in first dorsal interosseous Medical Research Council grade at final follow-up and time to reinnervation. Change in key pinch strength; grip strength; and Disabilities of the Arm, Shoulder and Hand questionnaire scores were also evaluated using paired t tests and Wilcoxon signed rank tests. Results Forty-two patients with severe cubital tunnel syndrome were included in this study. Other than age, there were no significant clinical or diagnostic variables that were predictive of failure. There was no threshold of compound muscle action potential amplitude below which supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer was unsuccessful. Conclusions This study provides the first cohort of outcomes following supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer in chronic ulnar compression neuropathy alone and underscores the importance of appropriate patient selection. Prospective cohort studies and randomized controlled trials with standardized outcome measures are required. Clinical question/level of evidence Therapeutic, IV.

  • supercharge end to side anterior interosseous to ulnar motor nerve transfer restores Intrinsic Function in cubital tunnel syndrome
    Plastic and Reconstructive Surgery, 2020
    Co-Authors: Jana Dengler, Lorna C. Kahn, Utku Can Dolen, Kristen M Davidge, Jennifer Mm Patterson, Susan E Mackinnon
    Abstract:

    BACKGROUND The supercharge end-to-side anterior interosseous nerve (AIN)-to-ulnar motor nerve transfer (SETS) offers a viable option to enhance recovery of Intrinsic Function following ulnar nerve injury. However, in the setting of chronic ulnar nerve compression neuropathy where the timing of onset of axonal loss is unclear, there is a deficit in the literature on outcomes after SETS nerve transfer. METHODS A retrospective study of patients who underwent SETS for severe cubital tunnel syndrome over a 5 year period was performed. The primary outcomes were improvement in first dorsal interosseous (FDI) Medical Research Council (MRC) grade at final follow-up and time to re-innervation. Change in key pinch strength, grip strength, and Disabilities of the Arm Shoulder and Hand (DASH) questionnaire scores were also evaluated using paired t-tests and Wilcox signed-rank tests. RESULTS Forty-two patients with severe cubital tunnel syndrome were included in this study. 3Other than age, there were no significant clinical or diagnostic variables that were predictive of failure. There was no threshold of CMAP amplitude below which SETS was unsuccessful. CONCLUSION This study provides the first cohort of outcomes following SETS in chronic ulnar compression neuropathy alone and underscores the importance of appropriate patient selection. Prospective cohort studies and randomized controlled trials with standardized outcome measures are required.

  • the supercharge end to side anterior interosseous to ulnar motor nerve transfer for restoring Intrinsic Function clinical experience
    Plastic and Reconstructive Surgery, 2015
    Co-Authors: Kristen M Davidge, Amy M Moore, Susan E Mackinnon
    Abstract:

    Background:The authors reviewed their initial clinical experience with the supercharge end-to-side anterior interosseous–to–ulnar motor nerve transfer and refined their indications for this technique.Methods:A retrospective cohort study was performed of all patients undergoing the supercharge end-to

  • direct radial to ulnar nerve transfer to restore Intrinsic muscle Function in combined proximal median and ulnar nerve injury case report and surgical technique
    Journal of Hand Surgery (European Volume), 2014
    Co-Authors: Benjamin Z Phillips, Susan E Mackinnon, Andrew Yee, Michael J Franco, Thomas H Tung, Ida K Fox
    Abstract:

    A distal median to ulnar nerve transfer for timely restoration of critical Intrinsic muscle Function is possible in isolated ulnar nerve injuries but not for combined ulnar and median nerve injuries. We used a distal nerve transfer to restore ulnar Intrinsic Function in the case of a proximal combined median and ulnar nerve injury. Transfer of the nonessential radial nerve branches to the abductor pollicis longus, extensor pollicis brevis, and extensor indicis proprius to the motor branch of the ulnar nerve was performed in a direct end-to-end fashion via an interosseous tunnel. This method safely and effectively restored Intrinsic Function before terminal muscle degeneration.

  • transfer of the extensor digiti minimi and extensor carpi ulnaris branches of the posterior interosseous nerve to restore Intrinsic hand Function case report and anatomic study
    Journal of Hand Surgery (European Volume), 2013
    Co-Authors: Thomas H Tung, John R Barbour, Gil Gontre, Gurpreet Daliwal, Susan E Mackinnon
    Abstract:

    Purpose To present a technique for restoration of ulnar Intrinsic Function using a nerve transfer of the extensor carpi ulnaris (ECU) and extensor digiti minimi (EDM) nerve branches of the posterior interosseous nerve (PIN) to the deep branch of the ulnar nerve in the forearm when the anterior interosseous nerve is unavailable. Methods We dissected 6 cadaveric upper extremities to identify the location of the EDM and ECU branches of the PIN and their distance to the ulnar nerve near the wrist. We present a case of a high combined median and ulnar nerve injury. We performed transfer of the EDM branch and 1 of the branches to the ECU of the PIN to the motor component of the ulnar nerve for Intrinsic hand Function. Results Our anatomic data demonstrate the branching pattern of the PIN and the length of regeneration and nerve graft required. Our patient required a 10-cm nerve graft, and the length of regeneration to reach the wrist was 19 cm. The patient recovered useful but incomplete reinnervation of the Intrinsic muscles and rated hand recovery at 70%. Conclusions Transfer of the EDM and ECU branches of the PIN to the motor component of the ulnar nerve is feasible with the use of a nerve graft. Using some of the branches to the ECU as well increases the axonal load to maximize muscle reinnervation. Clinical relevance Proximal ulnar nerve injuries with paralysis of the Intrinsic hand muscles lead to severe disability. Distal nerve transfers eliminate key factors that result in poor outcomes by allowing for faster muscle reinnervation. This nerve transfer had no Functional donor morbidity and could be useful in the setting of a combined high median and ulnar nerve injury.

Kristen M Davidge - One of the best experts on this subject based on the ideXlab platform.

  • supercharge end to side anterior interosseous to ulnar motor nerve transfer restores Intrinsic Function in cubital tunnel syndrome
    Plastic and Reconstructive Surgery, 2020
    Co-Authors: Jana Dengler, Andrew Yee, Lorna C. Kahn, Utku Can Dolen, Jennifer Megan M Patterson, Kristen M Davidge, Susan E Mackinnon
    Abstract:

    Background The supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer offers a viable option to enhance recovery of Intrinsic Function following ulnar nerve injury. However, in the setting of chronic ulnar nerve compression where the timing of onset of axonal loss is unclear, there is a deficit in the literature on outcomes after supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer. Methods A retrospective study of patients who underwent supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer for severe cubital tunnel syndrome over a 5-year period was performed. The primary outcomes were improvement in first dorsal interosseous Medical Research Council grade at final follow-up and time to reinnervation. Change in key pinch strength; grip strength; and Disabilities of the Arm, Shoulder and Hand questionnaire scores were also evaluated using paired t tests and Wilcoxon signed rank tests. Results Forty-two patients with severe cubital tunnel syndrome were included in this study. Other than age, there were no significant clinical or diagnostic variables that were predictive of failure. There was no threshold of compound muscle action potential amplitude below which supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer was unsuccessful. Conclusions This study provides the first cohort of outcomes following supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer in chronic ulnar compression neuropathy alone and underscores the importance of appropriate patient selection. Prospective cohort studies and randomized controlled trials with standardized outcome measures are required. Clinical question/level of evidence Therapeutic, IV.

  • supercharge end to side anterior interosseous to ulnar motor nerve transfer restores Intrinsic Function in cubital tunnel syndrome
    Plastic and Reconstructive Surgery, 2020
    Co-Authors: Jana Dengler, Lorna C. Kahn, Utku Can Dolen, Kristen M Davidge, Jennifer Mm Patterson, Susan E Mackinnon
    Abstract:

    BACKGROUND The supercharge end-to-side anterior interosseous nerve (AIN)-to-ulnar motor nerve transfer (SETS) offers a viable option to enhance recovery of Intrinsic Function following ulnar nerve injury. However, in the setting of chronic ulnar nerve compression neuropathy where the timing of onset of axonal loss is unclear, there is a deficit in the literature on outcomes after SETS nerve transfer. METHODS A retrospective study of patients who underwent SETS for severe cubital tunnel syndrome over a 5 year period was performed. The primary outcomes were improvement in first dorsal interosseous (FDI) Medical Research Council (MRC) grade at final follow-up and time to re-innervation. Change in key pinch strength, grip strength, and Disabilities of the Arm Shoulder and Hand (DASH) questionnaire scores were also evaluated using paired t-tests and Wilcox signed-rank tests. RESULTS Forty-two patients with severe cubital tunnel syndrome were included in this study. 3Other than age, there were no significant clinical or diagnostic variables that were predictive of failure. There was no threshold of CMAP amplitude below which SETS was unsuccessful. CONCLUSION This study provides the first cohort of outcomes following SETS in chronic ulnar compression neuropathy alone and underscores the importance of appropriate patient selection. Prospective cohort studies and randomized controlled trials with standardized outcome measures are required.

  • the supercharge end to side anterior interosseous to ulnar motor nerve transfer for restoring Intrinsic Function clinical experience
    Plastic and Reconstructive Surgery, 2015
    Co-Authors: Kristen M Davidge, Amy M Moore, Susan E Mackinnon
    Abstract:

    Background:The authors reviewed their initial clinical experience with the supercharge end-to-side anterior interosseous–to–ulnar motor nerve transfer and refined their indications for this technique.Methods:A retrospective cohort study was performed of all patients undergoing the supercharge end-to

Andrew Yee - One of the best experts on this subject based on the ideXlab platform.

  • supercharge end to side anterior interosseous to ulnar motor nerve transfer restores Intrinsic Function in cubital tunnel syndrome
    Plastic and Reconstructive Surgery, 2020
    Co-Authors: Jana Dengler, Andrew Yee, Lorna C. Kahn, Utku Can Dolen, Jennifer Megan M Patterson, Kristen M Davidge, Susan E Mackinnon
    Abstract:

    Background The supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer offers a viable option to enhance recovery of Intrinsic Function following ulnar nerve injury. However, in the setting of chronic ulnar nerve compression where the timing of onset of axonal loss is unclear, there is a deficit in the literature on outcomes after supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer. Methods A retrospective study of patients who underwent supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer for severe cubital tunnel syndrome over a 5-year period was performed. The primary outcomes were improvement in first dorsal interosseous Medical Research Council grade at final follow-up and time to reinnervation. Change in key pinch strength; grip strength; and Disabilities of the Arm, Shoulder and Hand questionnaire scores were also evaluated using paired t tests and Wilcoxon signed rank tests. Results Forty-two patients with severe cubital tunnel syndrome were included in this study. Other than age, there were no significant clinical or diagnostic variables that were predictive of failure. There was no threshold of compound muscle action potential amplitude below which supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer was unsuccessful. Conclusions This study provides the first cohort of outcomes following supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer in chronic ulnar compression neuropathy alone and underscores the importance of appropriate patient selection. Prospective cohort studies and randomized controlled trials with standardized outcome measures are required. Clinical question/level of evidence Therapeutic, IV.

  • direct radial to ulnar nerve transfer to restore Intrinsic muscle Function in combined proximal median and ulnar nerve injury case report and surgical technique
    Journal of Hand Surgery (European Volume), 2014
    Co-Authors: Benjamin Z Phillips, Susan E Mackinnon, Andrew Yee, Michael J Franco, Thomas H Tung, Ida K Fox
    Abstract:

    A distal median to ulnar nerve transfer for timely restoration of critical Intrinsic muscle Function is possible in isolated ulnar nerve injuries but not for combined ulnar and median nerve injuries. We used a distal nerve transfer to restore ulnar Intrinsic Function in the case of a proximal combined median and ulnar nerve injury. Transfer of the nonessential radial nerve branches to the abductor pollicis longus, extensor pollicis brevis, and extensor indicis proprius to the motor branch of the ulnar nerve was performed in a direct end-to-end fashion via an interosseous tunnel. This method safely and effectively restored Intrinsic Function before terminal muscle degeneration.

  • distal median to ulnar nerve transfers to restore ulnar motor and sensory Function within the hand technical nuances
    Neurosurgery, 2009
    Co-Authors: Justin Brown, Andrew Yee, Susan E Mackinnon
    Abstract:

    ULNAR NERVE INJURIES can be severely debilitating and result in weakness of wrist flexion, loss of hand Intrinsic Function, and ulnar-sided hand anesthesia. When these injuries produce a Sunderland fourth- or fifth-degree injury, surgical intervention is necessary for Functional recovery. Traditional methods for restoring hand Intrinsic Function after ulnar nerve palsy include interposition nerve grafting for timely presentations or tendon transfers for either complex injuries or late presentations. Distal median to ulnar nerve transfer to restore ulnar Intrinsic nerve muscle Function was first performed in 1991. We continue to find it advantageous for recovery of ulnar Intrinsic Function in patients with proximal ulnar nerve injuries by significantly reducing denervation time and directing motor fibers into this critical motor distribution. Several case reports have been published discussing the concept behind this approach, but none have outlined the specific steps involved in this operation. As such, this article discusses our operative methodology behind the distal median to ulnar neurotization, which includes a Guyon canal release, identification of donor median and recipient ulnar nerve fascicular anatomy within the forearm, and an operative tutorial on proper technique for neurotization to restore both ulnar motor and sensory Function. We present the technical nuances of the following nerve transfers to restore ulnar nerve Function within the hand: anterior interosseous nerve to deep motor branch of ulnar nerve, third webspace sensory contribution of median nerve to volar sensory component of ulnar nerve, and end-to-side reinnervation of ulnar dorsal cutaneous to the remaining median sensory trunk.

Jana Dengler - One of the best experts on this subject based on the ideXlab platform.

  • supercharge end to side anterior interosseous to ulnar motor nerve transfer restores Intrinsic Function in cubital tunnel syndrome
    Plastic and Reconstructive Surgery, 2020
    Co-Authors: Jana Dengler, Andrew Yee, Lorna C. Kahn, Utku Can Dolen, Jennifer Megan M Patterson, Kristen M Davidge, Susan E Mackinnon
    Abstract:

    Background The supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer offers a viable option to enhance recovery of Intrinsic Function following ulnar nerve injury. However, in the setting of chronic ulnar nerve compression where the timing of onset of axonal loss is unclear, there is a deficit in the literature on outcomes after supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer. Methods A retrospective study of patients who underwent supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer for severe cubital tunnel syndrome over a 5-year period was performed. The primary outcomes were improvement in first dorsal interosseous Medical Research Council grade at final follow-up and time to reinnervation. Change in key pinch strength; grip strength; and Disabilities of the Arm, Shoulder and Hand questionnaire scores were also evaluated using paired t tests and Wilcoxon signed rank tests. Results Forty-two patients with severe cubital tunnel syndrome were included in this study. Other than age, there were no significant clinical or diagnostic variables that were predictive of failure. There was no threshold of compound muscle action potential amplitude below which supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer was unsuccessful. Conclusions This study provides the first cohort of outcomes following supercharge end-to-side anterior interosseous nerve-to-ulnar motor nerve transfer in chronic ulnar compression neuropathy alone and underscores the importance of appropriate patient selection. Prospective cohort studies and randomized controlled trials with standardized outcome measures are required. Clinical question/level of evidence Therapeutic, IV.

  • supercharge end to side anterior interosseous to ulnar motor nerve transfer restores Intrinsic Function in cubital tunnel syndrome
    Plastic and Reconstructive Surgery, 2020
    Co-Authors: Jana Dengler, Lorna C. Kahn, Utku Can Dolen, Kristen M Davidge, Jennifer Mm Patterson, Susan E Mackinnon
    Abstract:

    BACKGROUND The supercharge end-to-side anterior interosseous nerve (AIN)-to-ulnar motor nerve transfer (SETS) offers a viable option to enhance recovery of Intrinsic Function following ulnar nerve injury. However, in the setting of chronic ulnar nerve compression neuropathy where the timing of onset of axonal loss is unclear, there is a deficit in the literature on outcomes after SETS nerve transfer. METHODS A retrospective study of patients who underwent SETS for severe cubital tunnel syndrome over a 5 year period was performed. The primary outcomes were improvement in first dorsal interosseous (FDI) Medical Research Council (MRC) grade at final follow-up and time to re-innervation. Change in key pinch strength, grip strength, and Disabilities of the Arm Shoulder and Hand (DASH) questionnaire scores were also evaluated using paired t-tests and Wilcox signed-rank tests. RESULTS Forty-two patients with severe cubital tunnel syndrome were included in this study. 3Other than age, there were no significant clinical or diagnostic variables that were predictive of failure. There was no threshold of CMAP amplitude below which SETS was unsuccessful. CONCLUSION This study provides the first cohort of outcomes following SETS in chronic ulnar compression neuropathy alone and underscores the importance of appropriate patient selection. Prospective cohort studies and randomized controlled trials with standardized outcome measures are required.

Steven L Moran - One of the best experts on this subject based on the ideXlab platform.

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