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The Archives of Bone and Joint Surgery، جلد ۱۳، شماره ۶، صفحات ۳۴۹-۳۵۸
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عنوان انگلیسی Secondary Ulnar Nerve Reconstruction of High Ulnar Nerve Injuries: A Comparative Study of Sural Grafting and Anterior Interosseous Nerve Transfer
چکیده انگلیسی مقاله Objectives: High ulnar nerve injuries often cause severe functional impairment, and the best secondary repair method remains debated. This study compared the effectiveness of sural nerve grafting and anterior interosseous nerve (AIN) transfer following failed primary ulnar nerve repairs .Methods: This retrospective cohort study included 42 patients with isolated high ulnar nerve injuries who required secondary surgical intervention. Patients were allocated to either the sural nerve grafting (n = 23) or AIN transfer (n = 19) group based on predefined clinical criteria. Motor and sensory functions were assessed using the British Medical Research Council (BMRC) grading system and a two-point discrimination (2PD) test. Grip and pinch strength were measured, and functional recovery was evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Results: The AIN transfer group exhibited significantly superior motor recovery, with 68.5% of patients achieving BMRC grades M4–M5, compared to only 17.4% in the sural grafting group (P = 0.03). Sensory recovery was also markedly better in the AIN group, with a higher proportion of patients reaching BMRC sensory grades S3–S4 (P = 0.04). Additionally, the AIN transfer group demonstrated significantly greater grip strength (30.1 ± 6.1 kg vs. 24.3 ± 5.2 kg; P = 0.03) and pinch strength (7.2 ± 1.5 kg vs. 5.8 ± 1.3 kg; P = 0.04). Improvement in DASH scores was more substantial in the AIN group (–26.6 ± 5.7 vs. –14.6 ± 4.3; P = 0.02), indicating better functional recovery. Although the AIN group showed a trend toward improved 2PD, the difference was not statistically significant (P = 0.18). Conclusion: AIN transfer provides superior outcomes compared to sural nerve grafting for the secondary repair of high ulnar nerve injuries, demonstrating significantly enhanced motor and sensory recovery, grip and pinch strength, and overall functional improvement.  Level of evidence: III
کلیدواژه‌های انگلیسی مقاله Anterior Interosseous Nerve, High Ulnar Nerve Injury, Nerve graft, Nerve Transfer, Sural nerve
نویسندگان مقاله | Ali Dehghan Marvast
Department of Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran


| Mohsen Aliakbari
Department of Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran


| Amir Mohammad Monzavi
Department of Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran


| Ashkan Salehi
Department of Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran


| Mohammad Shahsavan
Department of Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
نشانی اینترنتی https://abjs.mums.ac.ir/article_25947.html
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زبان مقاله منتشر شده en
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نوع مقاله منتشر شده RESEARCH PAPER
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