Primary Microsurgical Repair of Ulnar Nerve Laceration at the wrist
Posted Apr 1, 2020, 7:40 PM UTC
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The nerve coaptation looks good and I don’t think there’s anything technically I would have done differently besides an AIN SETS transfer, though this injury level is too distal for that to be feasible. Also, I generally like to save nerve repairs until after the nearby tendon repairs are done.
2
Absolutely agree on the tendon being first in most cases. But when you're fixing an ulnar nerve and an FCU, kinda hard to do the nerve with a big bulky repaired FCU in the way.
Thought about the AIN "supercharge" but at this level it's not really an option.
3
The patient, 75yo RHD M, was cut by a shard of glass, left wrist. Also cut the FCU tendon and ulnar artery. The artery was clamped and tied off by general surgeons in trauma bay.
Amazingly, they did not tie off the nerve.
FCU was repaired after the nerve
Hand was well-perfused, thus artery was left alone.
Patient did fair. Some protective sensation returned by a year, ulnar motor is still very weak. But he is 75 and declined to undergo further procedures.