Repair of a median nerve transection injury using multiple nerve transfers, with long-term functional recovery
Complete loss of median nerve motor function is a rare but devastating injury. Loss of median motor hand function and upper-extremity pronation can significantly impact a patient's ability to perform many activities of daily living independently. The authors report the long-term follow-up in a case of median nerve motor fiber transection that occurred during an arthroscopic elbow procedure, which was then treated with multiple nerve transfers. Motor reconstruction used the nerves to the supinator and extensor carpi radialis brevis to transfer to the anterior interosseous nerve and pronator. Sensory sensation was restored using the lateral antebrachial cutaneous (LABC) nerve to transfer to a portion of the sensory component of the median nerve, and a second cable of LABC nerve as a direct median nerve sensory graft. The patient ultimately recovered near normal motor function of the median nerve, but had persistent pain symptoms 4 years postinjury.
Medical Subject Headings
Action Potentials; Activities of Daily Living; Arthroscopy (adverse effects); Elbow Joint (surgery); Electromyography; Female; Hand Strength; Humans; Median Nerve (injuries, physiopathology, surgery); Middle Aged; Muscle Strength; Neurosurgical Procedures (methods); Peripheral Nerves (physiopathology, surgery, transplantation); Physical Therapy Modalities; Postoperative Complications (physiopathology, therapy); Radial Nerve (physiopathology, transplantation); Recovery of Function; Sensation; Sensory Receptor Cells (transplantation); Treatment Outcome
Journal of neurosurgery
Digital Object Identifier (DOI)
Murphy, Rory K.; Ray, Wilson Z.; and Mackinnon, Susan E., "Repair of a median nerve transection injury using multiple nerve transfers, with long-term functional recovery" (2012). Neurosurgery. 1490.