The hand diagram: A novel outcome measure following supercharged end-to-side anterior interosseous nerve to ulnar nerve transfer in severe compressive ulnar neuropathy.

Abduction tracing Cubital tunnel syndrome Nerve transfer Outcome measure Rehabilitation Severe ulnar neuropathy

Journal

Journal of hand therapy : official journal of the American Society of Hand Therapists
ISSN: 1545-004X
Titre abrégé: J Hand Ther
Pays: United States
ID NLM: 8806591

Informations de publication

Date de publication:
17 Oct 2023
Historique:
received: 03 05 2022
revised: 06 09 2023
accepted: 16 09 2023
medline: 20 10 2023
pubmed: 20 10 2023
entrez: 20 10 2023
Statut: aheadofprint

Résumé

With advances in the surgical management for severe ulnar neuropathy with the introduction of the super charged-end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfer, a simple and reliable outcome measure is required. There is currently not "one" standardized outcome measure used to represent and compare results. To present the abduction hand diagram as a "novel", reproducible, and simple outcome measure for patients with severe ulnar neuropathy. Retrospective case series. Nine patients with severe entrapment/compressive ulnar neuropathy at the elbow were reviewed. Clinical parameters included preoperative and postoperative abduction tracings, Medical Research Grade (MRC) muscle strength, key pinch strength, Disability of the Hand Arm and Shoulder (DASH) score, and crossed finger test. Electrodiagnostic data included change in compound muscle action potentials (CMAP) amplitude of the first dorsal interosseous (FDI), and abductor digiti minimi (ADM). Summary statistics were used for demographic and clinical data. Average follow-up was 22.8 ± 9.3 months. At 18-months of follow up, 44% had ADM MRC grade 3 strength or higher, mean key pinch strength improved to 72 ± 19.3%, and mean DASH was 33 ± 28.7. There was a mean increase of 16.7 ± 9.1 mm and 31.5 ± 12 mm in total and summed hand abduction tracing measurements respectively. Hand abduction tracings are a quantitative outcome measure to follow recovery over time for intrinsic hand function and can be used in patients with severe ulnar neuropathy following surgical intervention.

Sections du résumé

BACKGROUND BACKGROUND
With advances in the surgical management for severe ulnar neuropathy with the introduction of the super charged-end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfer, a simple and reliable outcome measure is required. There is currently not "one" standardized outcome measure used to represent and compare results.
PURPOSE OBJECTIVE
To present the abduction hand diagram as a "novel", reproducible, and simple outcome measure for patients with severe ulnar neuropathy.
STUDY DESIGN METHODS
Retrospective case series.
METHODS METHODS
Nine patients with severe entrapment/compressive ulnar neuropathy at the elbow were reviewed. Clinical parameters included preoperative and postoperative abduction tracings, Medical Research Grade (MRC) muscle strength, key pinch strength, Disability of the Hand Arm and Shoulder (DASH) score, and crossed finger test. Electrodiagnostic data included change in compound muscle action potentials (CMAP) amplitude of the first dorsal interosseous (FDI), and abductor digiti minimi (ADM). Summary statistics were used for demographic and clinical data.
RESULTS RESULTS
Average follow-up was 22.8 ± 9.3 months. At 18-months of follow up, 44% had ADM MRC grade 3 strength or higher, mean key pinch strength improved to 72 ± 19.3%, and mean DASH was 33 ± 28.7. There was a mean increase of 16.7 ± 9.1 mm and 31.5 ± 12 mm in total and summed hand abduction tracing measurements respectively.
CONCLUSIONS CONCLUSIONS
Hand abduction tracings are a quantitative outcome measure to follow recovery over time for intrinsic hand function and can be used in patients with severe ulnar neuropathy following surgical intervention.

Identifiants

pubmed: 37858501
pii: S0894-1130(23)00132-1
doi: 10.1016/j.jht.2023.09.005
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Sydney Knight (S)

Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. Electronic address: Sydney.Knight@lhsc.on.ca.

Thomas A Miller (TA)

Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Parkwood Institute Research, Parkwood Institute, London, Ontario, Canada; Parkwood Institute, St. Joseph's Healthcare, London, Ontario, Canada.

Amanda McIntyre (A)

Parkwood Institute Research, Parkwood Institute, London, Ontario, Canada.

Juliana Larocerie-Salgado (J)

Division of Hand Therapy, Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Ontario, Canada.

Douglas C Ross (DC)

Division of Plastic Surgery, Roth McFarlane Hand and Upper Limb Centre, St Joseph's Health Centre, London, Ontario, Canada.

Classifications MeSH