Complete loss of median nerve motor function is a rare but devastating injury. Loss of median motor hand function and upper-extremity pronation can significantly impact a patient's ability to perform many activities of daily living independently. The authors report the long-term follow-up in a case of median nerve motor fiber transection that occurred during an arthroscopic elbow procedure, which was then treated with multiple nerve transfers. Motor reconstruction used the nerves to the supinator and extensor carpi radialis brevis to transfer to the anterior interosseous nerve and pronator. Sensory sensation was restored using the lateral antebrachial cutaneous (LABC) nerve to transfer to a portion of the sensory component of the median nerve, and a second cable of LABC nerve as a direct median nerve sensory graft. The patient ultimately recovered near normal motor function of the median nerve, but had persistent pain symptoms 4 years postinjury.
Abbreviations used in this paper:AIN = anterior interosseous nerve; ECRB = extensor carpi radialis brevis; FDP = flexor digitorum profundus; FPL = flexor pollicis longus; IP = interphalangeal; LABC = lateral antebrachial cutaneous; PT = pronator teres.
Address correspondence to: Susan E. Mackinnon, M.D., Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, Missouri 63110. email: email@example.com.
Please include this information when citing this paper: published online September 14, 2012; DOI: 10.3171/2012.8.JNS111356.
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