gms | German Medical Science

Objectives/Interrogation: We report the results of reconstruction of fingertip sensation of thumb and index by modified distal sensory nerve transfer of superficial branch of radial nerve or dorsal branch of ulnar nerve in 6 patients with high median nerve lesions.

Methods: The 6 patients in this group are these with high median nerve lesions which could not repaired directly for some reasons. All had surgery during 7-14 mouths of trauma. For isolated nerve lesions, branches of the radial nerve on the proximal phalanx of the index and thumb were sutured to the ulnar proper digital nerve of thumb and radial proper digital nerve of the index finger in 3 patients. Whereas part of dorsal cutaneous ulnar nerve is transferred to fascicular group of median nerve including the radial digital nerve of index and both sides digital nerves of thumb at the wrist in those 3 patients with concomitant radial nerve palsies. Patients were followed up for at least 12 mouths.

Results and Conclusions: Either sensory nerve transfer restored protective or better sensation to the fingertips in all patients. Better locognosia was acquired in all thumbs whatever the transfer is. Good results were observed in patients who had undergone surgery later than 12 mouths after injury. Little paraesthesia of corresponding area of donor nerve is presented without trouble in either transfer.

Fingertip sensation of thumb and index finger could be effectively restored by sensory transfer of either radial nerve branches to palmar nerves at the level of the proximal phalanx or partial ulnar dorsal cutaneous branches to fascicular group of median nerve at wrist in high median nerve lesions. These two transfer maybe also be suitable for chronic low median nerve lesions or lesions in older patients, as a adjunct to nerve grafting.