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The Journal of Bone and Joint Surgery 83:549 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Selective Restoration of Motor Function in the Ulnar Nerve by Transfer of the Anterior Interosseous Nerve

An Anatomical Feasibility Study

Mehmet Erkan Üstün, MD, Tunç Cevat Ögün, MD, Mustafa Büyükmumcu, PhD and Ahmet Salbacak, PhD

Investigation performed at Selçuk University Medical School, Konya, Turkey
Mehmet Erkan Üstün, MD Tunç Cevat Ögün, MD Mustafa Büyükmumcu, PhD Ahmet Salbacak, PhD Department of Neurosurgery (M.E.Ü.), Division of Hand-Upper Extremity-Microsurgery, Department of Orthopedics and Traumatology (T.C.Ö.), and Department of Anatomy (M.B. and A.S.), Selçuk University, Kennedy cad. Billur sok., 44/10 06700, G.O.P. Ankara, Turkey. E-mail address for T.C. Ögün: tunccevat{at}hotmail.com
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.

Background:

Proximal ulnar-nerve lesions have an unfavorable prognosis. The goal of the present study was to evaluate the feasibility of selective restoration of motor function of the ulnar nerve by the transfer of the anterior interosseous nerve or one of its branches to the motor branch of the ulnar nerve.

Methods:

Ten cadaveric arms were used in the present study. The ulnar nerve and its motor and sensory branches as well as the anterior interosseous nerve and its branches were dissected. The widths of the motor branch of the ulnar nerve and the anterior interosseous nerve and its motor branches as well as the relevant distances from the points of divergence were measured. The axons were counted, and the distances from the end of the main anterior interosseous nerve, its motor branches, and the motor branch of the ulnar nerve to the level of the dorsal sensory branch of the ulnar nerve were measured.

Results:

Our results indicate that the length, width, and number of axons of the branch of the anterior interosseous nerve to the pronator quadratus make it suitable for transfer to the motor branch of the ulnar nerve. The use of the main anterior interosseous nerve or its motor branches to the flexor pollicis longus and the flexor digitorum profundus is less feasible because of the need to graft a long segment and the longer distance from the level of transfer to the motor end points.

Conclusions:

The findings of the present study confirm the feasibility of motor-nerve transfer for reconstruction after an injury of the ulnar nerve. Nerve-grafting would be needed for injuries distal to the level of the dorsal sensory branch of the ulnar nerve.


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