Abstract
Nerve transfers allow for re-innervation of the affected nerve from an adjacent nerve source in order to innervate a distal target muscle. We report a case involving extensive loss of soft tissue and loss of the ulnar nerve at the elbow joint. The size of the soft tissue defect was 20×14 cm, and the defect along the path of the ulnar nerve was approximately 20 cm. The defect in the soft tissue at the elbow joint was reconstructed using a thoracodorsal artery perforator (TAP) flap. The distal anterior interosseous nerve was transferred to the deep motor branch of the ulnar nerve to correct the nerve defect. Eighteen months after surgery, the patient was able to fully adduct the thumb. After the final follow-up, the pinch strength recovered to 2.5 kg and the Highet-Zachary scale grade was M3.
The method of nerve transfer described here utilizes the distal anterior interosseous nerve to innervate the intrinsic muscles of the hand. It is a simple method of re-establishing hand functionality.
