Long-term results of primary repair of combined cuts on the median and ulnar nerves in the forearm

WOS: 000416066800010PubMed ID: 29052828BACKGROUND: The objective of this clinical study was to evaluate sensory and motor functions in the later period following primary repair of combined injuries of the ulnar and median nerves in the forearm at proximal, middle, and distal levels. METHODS: Later period sensory evaluation of ulnar and median combined cuts was performed using two-point discrimination and monofilament tests. On the other hand, motor evaluation was performed by determining dorsal palmar interosseus strength for the ulnar nerve and abductor pollicis brevis muscle strength for the median nerve. Cold intolerance, object recognition, and weight discrimination were also reviewed. RESULTS: In total, 26 patients with ulnar-median combined cut and aged between 5 and 59 years were included in this study. Although no deficiency was observed in the sensory functions of any of the patients, a decrease in tactile sensation was detected in the median sensory region in 12 (46%) patients and in the ulnar sensory region in 7 (26%) patients. The most significant loss in terms of motor functions was detected in the opposition pinch strength. Two patients developed claw hand and two showed joint contracture. CONCLUSION: Ideal treatment for peripheral nerve injuries should be primary repair. Restoration of the motor function in the median nerve is relatively easier than that in the ulnar nerve. No significant difference was observed in terms of sensory function. An alternative is needed for primary repair because of lack of motor function in proximal ulnar incisions. There is no standardization of tests performed for peripheral nerve repair

Validity of ultrasonography in surgically treated zone 2 flexor tendon injuries

Objectives: The purpose of this study was to determine the validity of ultrasonography (USG) with surgical confirmation in surgically treated zone 2 flexor tendon injuries

Comparison of ultrasound and dorsal horizon radiographic view for the detection of dorsal screw penetration

WOS: 000422850300004PubMed ID: 29092760Objective: The aim of this study was to compare the efficiency of dorsal tangential fluoroscopy and ultrasonography in detecting dorsal screw penetration in distal radius volar locking plate applications. Methods: Ten cadaveric forearms were operated. The distal four screws were protruded 0, 1 and 2 mm into each of the second, third and fourth dorsal compartments of distal radius. Dorsal horizon views were taken using fluoroscopy. Each radiographic image was evaluated by two orthopedic surgeons who are blinded to procedure. Sonographic evaluations were performed by an orthopedic surgeon blinded to the procedure. Both dorsal horizon view and ultrasonography assessments were noted by the evaluators whether the tip of the screw penetrated or not the dorsal cortex for each compartment. Results: No significant difference was observed on correct detection of 0 mm, 1 mm and 2 mm screw penetrations at second and third compartments. In the fourth compartment, there was no difference with 0 mm and 2 mm penetrations but correct detection accuracy of 1 mm screw penetration was 87% in ultrasonography group and 71% in dorsal horizon view group. Conclusions: The accuracy of ultrasonography on 1 mm penetration at the fourth compartment is better than dorsal horizon view. However, dorsal horizon view and ultrasonography accuracy is similar for the other compartments and penetration levels. Ultrasonography is a reliable and effective procedure for detection of dorsal screw penetrations. (c) 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V