CLINICAL AND ELECTRONEUROGRAPHIC EVALUATION OF SENSORY MOTOR-DIFFERENTIATED NERVE REPAIR IN THE HAND

In 17 patients acetylcholinesterase activity was used to differentiate between sensory and motor fascicles in median and ulnar nerve repair of the hand. Eleven patients received follow-up evaluation 1 to 11 yea rs after surgery, and at that time clinical and electroneurographic ex aminations were performed to evaluate the techniques. Clinical examina tion showed that four patients had regained on average 71.9% of hand f unction after median nerve repair, one patient had regained 83.6% of h and function after ulnar nerve repair, four patients had regained on a verage 53.3% of hand function after median and ulnar nerve repair, and two patients had regained on average 43.5% of hand function after med ian and partial ulnar nerve repair. The contribution of the ulnar nerv e to reinnervation of the thenar muscles was 68.5%, whereas the median nerve did not contribute to reinnervation of the hypothenar muscles. Distal latencies for the median nerve showed a delay of 36% of the upp er limit of normal value, and those for the ulnar nerve revealed a del ay of 21.5%. This study demonstrated that sensory/motor-differentiated nerve repair of the median and ulnar nerves is possible and can be pr oven electroneurographically.