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Evaluation of Intrinsic Hand Musculature Reinnervation following Supercharge End-to-Side Anterior Interosseous-to-Ulnar Motor Nerve Transfer.
Plast Reconstr Surg. 2020 Jul; 146(1):128-132.PR

Abstract

Supercharge end-to-side anterior interosseous-to-ulnar motor nerve transfer is commonly performed in the authors' institution to augment intrinsic hand function. Following observations of recovery patterns, the authors hypothesized that despite its more distal innervation, the first dorsal interosseous muscle recovers to a greater extent than the abductor digiti minimi muscle. The objective of this work was to evaluate the clinical and electrodiagnostic pattern of reinnervation of intrinsic hand musculature following supercharge end-to-side anterior interosseous-to-ulnar motor nerve transfer. A retrospective cohort of prospectively collected data included all patients who underwent a supercharge end-to-side anterior interosseous-to-ulnar motor nerve transfer. Two independent reviewers performed data collection. Reinnervation was assessed with two primary outcome measures: (1) clinically, with serial Medical Research Council strength assessments; and (2) electrodiagnostically, with serial motor amplitude measurements. Statistical analysis was performed using nonparametric statistics. Seventeen patients (65 percent male; mean age, 56.9 ± 13.3 years) were included with a mean follow-up of 16.7 ± 8.5 months. Preoperatively, all patients demonstrated clinically significant weakness and electrodiagnostic evidence of denervation. Postoperatively, strength and motor amplitude increased significantly for both the first dorsal interosseous muscle (p = 0.002 and p = 0.016) and the abductor digiti minimi muscle (p = 0.044 and p = 0.015). Despite comparable preoperative strength (p = 0.098), postoperatively, the first dorsal interosseous muscle achieved significantly greater strength when compared to the abductor digiti minimi muscle (p = 0.023). Following supercharge end-to-side anterior interosseous-to-ulnar motor nerve transfer, recovery of intrinsic muscle function differs between the abductor digiti minimi and the first dorsal interosseous muscles, with better recovery observed in the more distally innervated first dorsal interosseous muscle. Further work to elucidate the underlying physiologic and anatomical basis for this discrepancy is indicated. CLINICAL QUESTION/

LEVEL OF EVIDENCE:

: Therapeutic, IV.

Authors+Show Affiliations

Ottawa, Ontario, and Vancouver, British Columbia, Canada From the Division of Plastic and Reconstructive Plastic Surgery, Department of Surgery, the Faculty of Medicine, and the Division of Physical Medicine and Rehabilitation, University of Ottawa; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of British Columbia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32590654

Citation

Head, Linden K., et al. "Evaluation of Intrinsic Hand Musculature Reinnervation Following Supercharge End-to-Side Anterior Interosseous-to-Ulnar Motor Nerve Transfer." Plastic and Reconstructive Surgery, vol. 146, no. 1, 2020, pp. 128-132.
Head LK, Zhang ZZ, Hicks K, et al. Evaluation of Intrinsic Hand Musculature Reinnervation following Supercharge End-to-Side Anterior Interosseous-to-Ulnar Motor Nerve Transfer. Plast Reconstr Surg. 2020;146(1):128-132.
Head, L. K., Zhang, Z. Z., Hicks, K., Wolff, G., & Boyd, K. U. (2020). Evaluation of Intrinsic Hand Musculature Reinnervation following Supercharge End-to-Side Anterior Interosseous-to-Ulnar Motor Nerve Transfer. Plastic and Reconstructive Surgery, 146(1), 128-132. https://doi.org/10.1097/PRS.0000000000006903
Head LK, et al. Evaluation of Intrinsic Hand Musculature Reinnervation Following Supercharge End-to-Side Anterior Interosseous-to-Ulnar Motor Nerve Transfer. Plast Reconstr Surg. 2020;146(1):128-132. PubMed PMID: 32590654.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of Intrinsic Hand Musculature Reinnervation following Supercharge End-to-Side Anterior Interosseous-to-Ulnar Motor Nerve Transfer. AU - Head,Linden K, AU - Zhang,Zach Z, AU - Hicks,Katie, AU - Wolff,Gerald, AU - Boyd,Kirsty U, PY - 2020/6/27/entrez PY - 2020/6/27/pubmed PY - 2020/6/27/medline SP - 128 EP - 132 JF - Plastic and reconstructive surgery JO - Plast. Reconstr. Surg. VL - 146 IS - 1 N2 - Supercharge end-to-side anterior interosseous-to-ulnar motor nerve transfer is commonly performed in the authors' institution to augment intrinsic hand function. Following observations of recovery patterns, the authors hypothesized that despite its more distal innervation, the first dorsal interosseous muscle recovers to a greater extent than the abductor digiti minimi muscle. The objective of this work was to evaluate the clinical and electrodiagnostic pattern of reinnervation of intrinsic hand musculature following supercharge end-to-side anterior interosseous-to-ulnar motor nerve transfer. A retrospective cohort of prospectively collected data included all patients who underwent a supercharge end-to-side anterior interosseous-to-ulnar motor nerve transfer. Two independent reviewers performed data collection. Reinnervation was assessed with two primary outcome measures: (1) clinically, with serial Medical Research Council strength assessments; and (2) electrodiagnostically, with serial motor amplitude measurements. Statistical analysis was performed using nonparametric statistics. Seventeen patients (65 percent male; mean age, 56.9 ± 13.3 years) were included with a mean follow-up of 16.7 ± 8.5 months. Preoperatively, all patients demonstrated clinically significant weakness and electrodiagnostic evidence of denervation. Postoperatively, strength and motor amplitude increased significantly for both the first dorsal interosseous muscle (p = 0.002 and p = 0.016) and the abductor digiti minimi muscle (p = 0.044 and p = 0.015). Despite comparable preoperative strength (p = 0.098), postoperatively, the first dorsal interosseous muscle achieved significantly greater strength when compared to the abductor digiti minimi muscle (p = 0.023). Following supercharge end-to-side anterior interosseous-to-ulnar motor nerve transfer, recovery of intrinsic muscle function differs between the abductor digiti minimi and the first dorsal interosseous muscles, with better recovery observed in the more distally innervated first dorsal interosseous muscle. Further work to elucidate the underlying physiologic and anatomical basis for this discrepancy is indicated. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV. SN - 1529-4242 UR - https://www.unboundmedicine.com/medline/citation/32590654/Evaluation_of_Intrinsic_Hand_Musculature_Reinnervation_following_Supercharge_End-to-Side_Anterior_Interosseous-to-Ulnar_Motor_Nerve_Transfer L2 - https://Insights.ovid.com/pubmed?pmid=32590654 DB - PRIME DP - Unbound Medicine ER -
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