Case ReportsAdductor Branch of Terminal Divisions of the Ulnar Nerve Transfer to the Thenar Motor Branch in a High Median Nerve Palsy A Case ReportJerome, J. Terrence Jose MBBS, FRCS(G), DNB, FNB (Hand & Micro), European Diploma Hand Surgery, FICS, PGDMLE(National Law School)1, Author Information 1Department of Orthopedics, Hand and Reconstructive Microsurgery, Olympia Hospital & Research Centre, Puthur, Trichy, Tamil Nadu, India aE-mail address for J.T.J. Jerome: [email protected] Investigation performed at Olympia Hospital and Research Centre, Trichy, Tamilnadu, India Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (https://links.lww.com/JBJSCC/C58). JBJS Case Connector 13(1):e22.00704, January-March 2023. | DOI: 10.2106/JBJS.CC.22.00704 Buy Associated Video Metrics Abstract Case: The author reports a 4-month-old high median nerve palsy in a 19-year-old man with right forearm fractures, stabilized with dynamic compression plates and screws. Surgical exploration revealed a large median nerve neuroma in the midarm that was excised, and the gap was bridged with sural nerve cable grafts. The extensor carpi radialis nerve was transferred to the anterior interosseous nerve in the forearm. The adductor branch of terminal divisions of the ulnar nerve was transferred to the thenar branch of the median nerve in the hand. Conclusions: The adductor branch of ulnar nerve transfer to the thenar motor branch in high median nerve palsy efficiently restored thumb opposition in 10 months of follow-up. In addition, the patient's grasp and pinch improved, preserving thumb adduction. Copyright © 2023 by The Journal of Bone and Joint Surgery, Incorporated
