Optimizing outcomes in ulnar nerve injuries: nerve grafting after primary neurorrhaphy

Victor Hugo Garzón Ortega; Verania Fernanda Hernández Barrón; Fernando Fernández Varela Gómez; Lucio Alejandro Santos Moyron; Alexander Cárdenas Mejía

doi:10.18203/2349-2902.isj20251174

Authors

Victor Hugo Garzón Ortega Department of Plastic and Reconstructive Surgery, Hospital General “Dr. Manuel Gea González”, Mexico City, Mexico
Verania Fernanda Hernández Barrón Department of Plastic and Reconstructive Surgery, Hospital General “Dr. Manuel Gea González”, Mexico City, Mexico
Fernando Fernández Varela Gómez Department of Plastic and Reconstructive Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Lucio Alejandro Santos Moyron Department of Plastic and Reconstructive Surgery, Hospital General “Dr. Manuel Gea González”, Mexico City, Mexico
Alexander Cárdenas Mejía Peripheral Nerve Clinic of Plastic and Reconstructive Surgery, Hospital General “Dr. Manuel Gea González”, Mexico City, Mexico

DOI:

https://doi.org/10.18203/2349-2902.isj20251174

Keywords:

Ulnar nerve injury, Nerve grafting, Neurorrhaphy, Peripheral nerve repair, QuickDASH

Abstract

This case series rigorously assesses the efficacy of primary neurorrhaphy followed by secondary nerve grafting in five patients with ulnar nerve injuries, utilizing the quick disabilities of the arm, shoulder, and hand (QuickDASH) score as a standardized measure of functional outcomes. Treated between 2019 and 2023, these patients underwent initial neurorrhaphy followed by nerve transfer. Functional assessments were conducted preoperatively, post-neurorrhaphy, and post-nerve transfer using the QuickDASH questionnaire. The mean preoperative QuickDASH score was 43.00 (standard deviation [SD]=7.34), improving to 36.20 (SD=6.54) after neurorrhaphy (mean difference=-6.8, p<0.01), and further to 24.20 (SD=2.59) after nerve transfer (mean difference=-12, p<0.01). Paired t-tests substantiated statistically significant enhancements in functional activity at each intervention stage (p<0.01). These results indicate that integrating primary neurorrhaphy with secondary nerve transfer effectively restores nerve function in acute ulnar nerve lacerations. This study underscores the potential of these combined surgical strategies to optimize outcomes in complex peripheral nerve injuries, though larger-scale investigations are warranted to confirm these findings.

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