The Sensory Restoration in Radial Nerve Injury Using the First Branch of Dorsal Ulnar Cutaneous Nerve - A Cadaveric Study for the Feasibility of Procedure and Case Demonstration

Sorasak Suppaphol MD*, Ittirat Watcharananan MD*, Tulyapruek Tawonsawatruk MD*, Patarawan Woratanarat MD*, Thananetr Sasivongsbhakdi MD*, Viroj Kawinwonggowit MD*

Affiliation : * Department of Orthopedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Objective : To demonstrate the new sensory restoration technique in radial nerve injury using the first branch of dorsal ulnar cutaneous nerve as the donor sensory nerve. Material and Method: Forty formalin-preserved cadavers (18 males and 22 females) were used as the subjects of the present study. The localization of the origin of first branch of dorsal ulnar cutaneous nerve was performed. The measurement was done to determine the origin of this nerve in relation to the tip of ulnar styloid. The simulated transfer was done. The length of the superficial radial nerve that had to be cut was determined. The measurement was done by two observers to determine the reliability of measurement.
Results : The mean horizontal distance (X) to the origin of first branch of dorsal ulnar cutaneous nerve measured from the tip of ulnar styloid on the right and left side were 5.22 mm and 6.51 mm respectively. The mean vertical distance (Y) to the origin of first branch of dorsal ulnar cutaneous nerve measured from the tip of ulnar styloid on the right and left side were -7.72 mm and -4.37 mm respectively. The mean length of superficial radial nerve that had to be cut to allow tension free anastomosis, measured from the tip of radial styloid on the right and left side were 68.21 mm and 65.92 mm respectively. The estimated average size of the transferred branch of ulnar cutaneous nerve was about 70% of the size of superficial radial nerve.
Conclusion : The sensory restoration in radial nerve injury using sensory nerve transfer from the first branch of dorsal ulnar cutaneous nerve was technically feasible regarding to the comparable size between two nerves and anatomic consistency of the first branch of dorsal ulnar cutaneous nerve.

Keywords : Radial nerve palsy, Sensory restoration, Nerve transfer

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