Motor and sensory reinnervation in the hand after an end-to-side median toulnar nerve coaptation in the forearm

End-to-side coaptation of the median to ulnar nerve through an epineurial w indow was performed 5 cm proximal to the wrist in a patient with high media n nerve injury associated with a 35 cm long nerve gap. Forty-three months a fter the operation, sensory examination revealed the presence of diminished protective sensation (3.61-4.31 NCM Semmes-Weinstein monofilament) in the large part of the median nerve dermatome. In the two-point discrimination t est, single point was perceived in the median nerve dermatome pointing to t he presence of protective sensation. MRI and EMG studies indicated limited motor reinnervation in the opponens pollicis muscle. This novel method of n erve repair may be chosen in the management of very long nerve gaps, where conventional methods are likely to give an unsuccessful result.