Journal Title: بهار 89
Article title: Comparison of Sensory Recovery Following the Repair of Ulnar and Median Nerves at the Wrist Level

Article PDF File:
Page From: 36 To: 44      
Article abstract:
Introduction & Objective: Traumatic nerve damage is quiet a frequent event in the upper extremity. Microscopic reconstructive nerve repair is usually used to restore the continuity of the injured nerve. Restoration of the sensory ability of the nerve is of great importance in normalization of the hand function. Since we could not find an individual study comparing the sensory out come between median and ulnar repair, we designed this study to better understand the results of sensational out comes between these two nerves. Materials & Methods: During 3 Months period, 65 patients who had median, ulnar or both nerves injuries at the wrist level, and who had been operated upon in Hazrat Fatemeh Hospital were assessed with regard sensibility improvement were compared with each other. The criterias for inclusion were negative history of medical illness and adequate follow-up (at last 9 months) after surgery. The sensory evaluation was performed by monofilament test, static and moving two point discrimination, and the results were compared. Results: Of the 65 patients included in this study, the mean age was 27.2 years. The cause of trauma was predominantly laceration with glass. Ulnar nerve was the most commonly injured nerve (46.2%) and sole median nerve injury was observed in 36.9% of patients. In 16.9% of the patients both ulnar and median nerve were damaged. The mean time for patient evaluation was 24.5 months after surgery. Middle finger was the mostly impaired one in the test after median nerve injuries and the little finger was the mostly impaired one in the tests after ulnar injuries. The results show that the sensory return is better and higher in median nerve repairs in comparison to ulnar nerve repairs at the wrist level. Conclusions: In upper limb nerve injuries, radial nerve has the best prognosis and the ulnar nerve has the worst one. In our study, however it is shown that in the same condition of age, cause of trauma, time elapsed before surgery and surgical method, sensory return in median nerve is better that ulnar nerve at wrist level. This can be due to less complexity of the median nerve in terms of anatomy and topography, smaller motor component and easier exposure during surgery. Also, the best area for evaluation of sensory impairment and return after median nerve injury is the volar side of middle finger.
Article KeyWords:
Ulnar Nerve, Median Nerve, Nerve Injury, Nerve Repair, Sensory Recovery
Article Authors:

	دکتر محمد جواد فاطمی	First Author	Fatemi41@Yahoo.com
	دکتر کمال سید فروتن	Other Author
	دکتر فاطمه رجبی	Other Author