gms | German Medical Science

Objectives/Interrogation: To compare combined ulnar nerve repair with supercharged end to side anterior interosseous nerve to ulnar motor nerve transfer (UR+SETS) to conventional isolated ulnar repair (IUR) techniques in proximal ulnar nerve transection

Methods: A comparative randomized trial was conducted prospectively on 30 patients with proximal ulnar nerve transection injury. Fifteen patients were managed by UR+SETS. Fifteen patients were managed by IUR. The level of injury was classified into 1-3 according to Post et al. [1] (Figure 1 [Fig. 1]). The outcome was compared at 3, 6, 12, 18 months using Birch's score and Brand's criteria.

Results and Conclusions: Only 13 patients in both groups completed their 18 months follow up. At the 3- month follow up, the results showed no statistically significant difference in outcomes between the two groups. At the 6-month follow up, the Birch's score was statistically insignificant. The Brand's score was better in the UR+SETS group, possibly indicating early return of function. At 12-18 months, there was a statistically significant difference in the outcomes in favour of UR+SETS group.

On comparing the outcome according to the level of injury: At level 1 injuries, UR+SETS group showed statistically significant higher Birch and Brand's scores. Although the sample size was small to be statistically analysed, the UR+SETS group showed better results than the IUR group in level 2 injuries. The preliminary results indicate that the 2 groups were comparable in level 3 injuries indicating that UR+SETS transfer may be of no value at that level of injury.

At the short term, UR+SETS transfer results in better intrinsic muscle re-innervation and clawing deformity correction following proximal ulna nerve transection injury.