Clinical and electroneurographic evaluation of sensory/motor-differentiated nerve repair in the hand

Abstract

✓ In 17 patients acetylcholinesterase activity was used to differentiate between sensory and motor fascicles in median and ulnar nerve repair of the hand. Eleven patients received follow-up evaluation 1 to 11 years after surgery, and at that time clinical and electroneurographic examinations were performed to evaluate the techniques. Clinical examination showed that four patients had regained on average 71.9% of hand function after median nerve repair, one patient had regained 83.6% of hand function after ulnar nerve repair, four patients had regained on average 53.3% of hand function after median and ulnar nerve repair, and two patients had regained on average 43.5% of hand function after median and partial ulnar nerve repair. The contribution of the ulnar nerve to reinnervation of the thenar muscles was 68.5%, whereas the median nerve did not contribute to reinnervation of the hypothenar muscles. Distal latencies for the median nerve showed a delay of 36% of the upper limit of normal value, and those for the ulnar nerve revealed a delay of 21.5%. This study demonstrated that sensory/motor-differentiated nerve repair of the median and ulnar nerves is possible and can be proven electroneurographically.