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Sensory restoration by lateral antebrachial cutaneous to ulnar nerve transfer in children with global brachial plexus injuries

  • Surgery Articles
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HAND

Abstract

Selective peripheral nerve transfers represent an emerging reconstructive strategy in the management of both pediatric and adult brachial plexus and peripheral nerve injuries. Transfer of the lateral antebrachial cutaneous nerve of the forearm into the distal ulnar nerve is a useful means to restore sensibility to the ulnar side of the hand when indicated. This technique is particularly valuable in the management of global brachial plexus birth injuries in children for which its application has not been previously reported. Four children ages 4 to 9 years who sustained brachial plexus birth injury with persistent absent sensibility on the unlar aspect of the hand underwent transfer of the lateral antebrachial cutaneous nerve to the distal ulnar nerve. In three patients, a direct transfer with a distal end-to-side repair through a deep longitudinal neurotomy was performed. In a single patient, an interposition nerve graft was required. Restoration of sensibility was evaluated by the “wrinkle test.”

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Conflict of interest disclosure

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Hand, Upper Extremity, and Microsurgery Service, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA

    David E. Ruchelsman

  2. Brachial Plexus and Peripheral Nerve Program, Miami Children’s Hospital, Miami, FL, USA

    Herbert Valencia, Lorna E. Ramos & John A. I. Grossman

  3. Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA

    Andrew E. Price & John A. I. Grossman

Authors
  1. David E. Ruchelsman
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  2. Andrew E. Price
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  3. Herbert Valencia
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  4. Lorna E. Ramos
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  5. John A. I. Grossman
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Corresponding author

Correspondence to John A. I. Grossman.

Additional information

Investigation performed at the NYU Hospital for Joint Diseases, New York, NY, and Miami Children’s Hospital, Miami, FL.

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Ruchelsman, D.E., Price, A.E., Valencia, H. et al. Sensory restoration by lateral antebrachial cutaneous to ulnar nerve transfer in children with global brachial plexus injuries. HAND 5, 370–373 (2010). https://doi.org/10.1007/s11552-010-9284-6

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  • DOI: https://doi.org/10.1007/s11552-010-9284-6

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