gms | German Medical Science

Objectives/Interrogation: Preserving the distal sensitivity of the upper limb is one of the fundamental objectives that should be sought when focusing and managing a patient who has a brachial plexus or peripheral nerve lesion; since this type of alteration increases the morbidity and the risk of suffering injuries such as burns, cuts, compression ischemia among others. Sensory transfers have become more important in the current management of brachial plexus injuries as they positively impact functional scales. The objective of the study is the identification of the innervation patterns of the ulnar ridge of the fifth finger and the digital ulnar sensory branch of the 3 finger, as well as surgical techniques for the sensitive recovery of the ulnar border of the hand.

Methods: descriptive study, dissection in cadaveres

Results and Conclusions: For this purpose, 20 cadaverous specimens were dissected and two techniques (end-terminal) are described: 1. the ulnar sensory branch of the third finger is taken as a donor and is transferred by subcutaneous tunnel to the recipient in the ulnar sensory branch of the 5 finger in the palm of the hand. 2. The ulnar sensory branch of the 5 finger is identified before the Guyon canal and the cutaneous palmar branch or the sensory branch for the third space is used as a donor at the proximal level. The cutaneous palmar was inconsistent in 50% of the components and in those that it was found, it had a caliber 50% lower than that of the receptor nerve. Given this finding, it was preferred to use the branch of the common digital nerve of the third space in the transfer at the level of the distal third of the forearm, but for this purpose it is necessary to identify it distal to the carpal tunnel and dissect it proximal to the wrist crease. to transfer it to the recipient, this second technique involves a greater dissection, longer surgical time and greater manipulation of the donor nerve, which is why we recommend carrying out the transfer at the level of the palm of the hand which has lower morbidity and meets the same objectives as the proximal transfer in terms of the expected results.