Supercharging of the ulnar nerve: clinical and neurophysiological assessment at 2 years for nine proximal injuries

Abstract

The aim of this study was to use detailed clinical and neurophysiological examinations to strengthen outcome assessment after supercharged end-to-side nerve transfer for ulnar nerve injury. The transfer was performed in nine adult patients with complete ulnar nerve injuries at or proximal to the elbow who also underwent primary nerve repair ( n = 7) or grafting ( n = 2) either concomitantly or within the previous 18 months. Patients were examined pre- and postoperatively with follow-ups at 9, 12 and 24 months, including detailed neurophysiological assessments. Motor recovery in the long flexors was seen at 9 months, but intrinsic function was first apparent from 12 months. Sensory recovery was also observed consistent with proximal reinnervation. Neurophysiological signs of function via the supercharged end-to-side nerve transfer were only seen for one patient. We conclude that the place for this technique in clinical practice still seems to be uncertain. Level of evidence: II