Study of patient and injury related prognostic predictors of motor and sensory recovery in Ulnar nerve injuries - A three-year experience at tertiary care hospital in Himalayan region

• Main Author: Tanveer Ahmed Bhat, Mir Mohsin, Nahida Wani, Haroon Rashid Zargar, Adil Hafeez Wani
• Format: Article
• Language: English
• Published: Bulgarian Association of Young Surgeons 2020-12-01
• Series: International Journal of Surgery and Medicine
• Subjects: hand trauma; nerve; tendon; artery; recovery
• Online Access: http://www.ejos.org/index.php?fulltxt=32492&fulltxtj=136&fulltxtp=136-1594111975.pdf

Background: Ulnar nerve integrity is a prerequisite for normal hand function. The ulnar nerve is a frequently injured nerve, and recent evidence indicates that nerve surgery may produce acceptable outcomes.The outcome of the ulnar nerve repair depends upon different factors.The present study provides the surgical outcome of ulnar nerve injuries and studies the patient and injury related factors as prognostic predictors of motor and sensory recovey. Materials and Methods: In this prospective study, patients with ulnar nerve injuries due to trauma, undergoing primary surgical repair by a single microsurgeon over a period of 3 years (Aug 2014 – Jul 2017) were selected.The demographic data, injury characteristics were studied and their impact on the surgical outcome assessed at 2- year follow-up. Results: A total of 62 patients (48 males and 14 females with a male: female ratio of 3.42:1) fulfilled the inclusion criteria. Majority of them [39/62 (62.90%)] were in the age group of 16 to 40 years. Glass cut and knife cut were the most common modes of injury in males 24/62(50%) and females 9/14(64.28%) respectively. At 2-year follow up, 80% children had good and motor recoveries while only in 30 % patients above 60 years of age fair recovery was reported.. In 85% of injuries at the wrist level, the outcome was good while in 70% of proximal forearm injuries, it was Fair. Sensory and motor recovery was good only in 32% of sharp injuries while as in the rest it was fair. In 70% of the subjects with associated injuries involving median nerve, both radial and ulnar arteries and all flexor tendons, recovery was fair while 30% of such cases had Poor results. Conclusions: We concluded that clean cut distal ulnar nerve injuries have good outcome in younger patients.Isolated ulnar nerve injury has good outcome but when associated with median nerve injury, tendon injury or double vessel injury, the outcome is Poor.