Player is loading...
A-0596 Clinical and neurophysiological results two years after transfer of the interosseous anterior nerve (AIN) to the deep motor branch of the Ulnar nerve (DBUN)
Rasmus Thorkildsen 1, Frode Thu 1, Lars-Eldar Myrseth 1, Ellen Jørum 2, Inge Petter Kleggetveit 2, Lise Maurstad 3, Bjørg Bolstad 3, Magne Røkkum 1,4, Oslo, Norway
Friday, June 15, 2018 · 6:24 p.m. · 06m 49s
Rasmus Thorkildsen 1, Frode Thu 1, Lars-Eldar Myrseth 1, Ellen Jørum 2, Inge Petter Kleggetveit 2, Lise Maurstad 3, Bjørg Bolstad 3, Magne Røkkum 1,4 1 Upper Extremity and Microsurgical Unit, Department of Orthopeadics, Oslo University Hospital, Oslo, Norway; 2 Neurological Department, Oslo University Hospital, Oslo, Norway; 3 Department for Clinical Service Orthopaedics, Oslo University Hospital, Oslo, Norway; 4 University of Oslo, Oslo, Norway
Embed
Embed code is not allowed
This talk is part of a Private webcast, embeding is not permited.Transcriptions
Note: this content has been automatically generated.
00:00:00
okay everybody thanks for inviting us to tell you about our experience with this uh
00:00:06
no transfers so this work started out as we wanted to improve
00:00:10
the results uh like many others from high on of lesions
00:00:14
um and as we said at using this into an twenty fifteen and we
00:00:18
wanted to um document our results prospectively but clinically and a lecture physiologically
00:00:24
and of course the inter site transfers to some uncontroversial so did we filled important to see if
00:00:30
we could documented actually working or not so it clinically will use the rose and score
00:00:36
uh in two thousand validated for um peripheral nerve injuries only going to
00:00:41
the specifics of it but it uh and it basically it's
00:00:45
equally weighted between the long flexes an intrinsic and muscles and it
00:00:49
also takes into account the ratio to the healthy side
00:00:52
expressed as it maximum score one yeah and then you're physiologically we
00:00:57
looked at a paper that came out in two thousand twelve
00:01:01
and but and what we're trying to show is a an increase compound most like
00:01:04
some potential you know only the nerve innovative muscle likely abducted eating meaning me
00:01:10
you expect an increased could see a component selection potential when you seem like
00:01:15
the meeting of uh bob the transfer at like the older reach
00:01:19
so these patients uh that we have i don't know how to be a follow up
00:01:24
for them uh sorry um there were first like to us most of these except
00:01:29
one that we operate acutely six one mile median age thirty nine all
00:01:34
right handed file left hand injury yeah only for them actually had or hadn't
00:01:39
ever pay at the all by one of these uh never off
00:01:43
the remaining where a a a mixture of texas injuries
00:01:47
a dash one homer with the uh post operative
00:01:50
complete omen of palsy and a a role injury to the upper um
00:01:56
within right brunette injury so i'm in most cases six out of eight we did and
00:02:02
decide transfer is uh at selectively to the motor branch of the on it
00:02:07
any two cases would even into and transfer because that these are
00:02:10
cases where we thought it would be no possibility approximately innovation
00:02:15
so our results um the only significant finding is actually the rose in
00:02:20
most uh school uh which improves that both one and two years
00:02:25
uh the quick dash also improves but there's a large range of results e. so it doesn't come up a significant the
00:02:31
pain strength uh change a little bit but not significantly ends up roughly on the half of the healthy side
00:02:38
but we did see significant improvement in both the formants on and the cooling
00:02:43
at three is six elevate passions had a mall or negative from
00:02:46
unsigned and seven added i'd had model or negative calling
00:02:51
so uh we also looked at the sensation uh now we
00:02:55
haven't done a sensory transfer here so it in the
00:02:59
sensor recovery would seem to be the proximal never covering from of the surgery or
00:03:05
from the legion are off six out of i have protective sensational better
00:03:11
so that gets more complicated than your physiology these we were only able to
00:03:16
show affects for three patients it registering in the abducted eating mini muscle
00:03:22
two of them martin asked fixes are the end to end transfer is a special form of
00:03:28
six and passion five most likely have the marching group earnestness that you know but
00:03:34
um and we see in raid writing um stimulating the median the recording
00:03:40
in your doctor between me similar to the former study absurd
00:03:43
improvement in the compound muscle action potential when we stimulated the l. but for both these patients
00:03:50
yeah that didn't actually call 'em correlate with the
00:03:54
clinical experience so these are two best patience
00:03:58
on your uh uh left his seventeen year old female grafted at the oh boy
00:04:03
so you wouldn't expect a very good recovery but she has an excellent
00:04:06
hand function within into side transfers six months after the nerve
00:04:10
graft and on your rights is forty one euro mile we we
00:04:15
did the rex suture an inside transfer at the same time
00:04:19
so this left the somewhat confused it's a small material but about
00:04:25
two thirds of operations have good recovery of intrinsic function
00:04:29
how within your physiology is only positive in three cases the ease have somewhat difficult to interpret
00:04:37
two of them were into n. connections and one lock women would bring us the most is how he
00:04:42
has improved from one city is so it would seem to be recovery through the inside transfer the
00:04:48
we don't have a clue correlation at this stage only few number of patients so we'll see when we have more
00:04:54
um and we see a tendency for the abducted these minima to have a better than the first all's interested so perhaps
00:05:00
we need does have along the follow up i think in conclusion was still confused or high level like you to
00:05:11
very like thanks very much to be have any questions please for this paper
00:05:19
the questions a tool ah certainly isn't
00:05:29
you should you have the same city for improvement also on the patient
00:05:34
yeah so you you went to sidebar comparable to branch
00:05:38
so you think it's stupid your or try to block to be the most to rule out which
00:05:44
which is coming from but we don't know if it's it's actually something we're thinking of doing it's
00:05:49
somewhat tricky of course to get licensed to uh agreed to this but if we if we
00:05:54
were able to do a a um a block of the online that i think
00:05:58
you would then prove a excess to hide good intrinsic function then that
00:06:02
would be at the proof of uh the trends that working
00:06:09
ah you're all just in your radiologists are using diffusion tense for imaging
00:06:15
in track talker feed to track to actually image where the nerves are
00:06:20
coming from the central nervous system or you might talk you radiologists
00:06:25
uh but using d. t. i. in the performer as well because it should be perfect
00:06:29
indication you could find out which tracks were actually getting to the muscles remuneration
00:06:33
we tried it it's very very difficult but um eventually gonna be able to use that
00:06:39
so but anyway because the thought i'll look into it
Conference Program
A-0358 New Open and Arthroscopic-Assisted Approaches of the Axillary Nerve
Andres A. Maldonado, Bassem T. Elhassan, Allen T. Bishop, Alex Y. Shin, Robert J. Spinner, 1 Department of Plastic, Hand and Reconstructive Surgery, BG Unfallklinik Frankfurt, Germany; 2 Department of Neurosurgery, Mayo Clinic, Rochester (MN), USA
June 15, 2018 · 6:17 p.m.
A-0596 Clinical and neurophysiological results two years after transfer of the interosseous anterior nerve (AIN) to the deep motor branch of the Ulnar nerve (DBUN)
Rasmus Thorkildsen 1, Frode Thu 1, Lars-Eldar Myrseth 1, Ellen Jørum 2, Inge Petter Kleggetveit 2, Lise Maurstad 3, Bjørg Bolstad 3, Magne Røkkum 1,4, Oslo, Norway
June 15, 2018 · 6:24 p.m.
128 views
