Introduction: Ulnar nerve injuries around the wrist result
in paralysis of intrinsic muscles and sensory loss of little
finger and ulnar half of ring finger. Formation of traumatic
neuroma of the ulnar nerve adds pain at the site of nerve
repairs.
Patients and Methods: 10 patients were included in this
study. Clinical, radiological and electrophysiological assessment
indicate surgery in these patients where neuroma was
excised, identification of sensory and motor fascicles of the
ulnar nerve was done and cable nerve grafts were used to
bridge the nerve defects. Assessment of the outcome was done
in patients who finished follow-up for at least one year.
Results: Pain at the site of neuroma disappeared after
surgery. All patients were followed-up and 6 patients needed
tendon transfer after one year. Sensory recovery was achieved
after one year. Trophic changes and cold intolerance was
improved.
Discussion: Primary repair of ulnar nerve injuries is the
gold standard treatment for such injuries. Claw hand, weakness
of the hand grip and abduction deformities are the main motor
defects which can be corrected by tendon transfers. However,
sensory defects and cold intolerance affected the outcome of
surgery. When the diagnosis of non-conducting neuroma is
made, neuroma resection and reconstruction improve the
clinical outcome.
Conclusion: The unfavorable outcomes of ulnar nerve
injuries can be improved by resection of neuroma in continuity
and nerve grafting. Multidisciplinary team is needed to achieve
the best clinical outcomes.