Restoration of sensibility in irreparable ulnar and median nerve lesions with use of sensory nerve transfer: Long-term follow-up of 20 cases

A prospective study was conducted to evaluate patient outcomes following se nsory nerve transfer. Twenty patients with irreparable ulnar or median nerv e lesions underwent the procedure. Nerve involvement was bilateral in 5 cas es. The mean age of the patients at the time of surgery was 29 years. The m ean paralysis time and the average length of follow-up were 59 and 78 month s, respectively. Eighteen of 20 patients attended a sensory re-education pr ogram after surgery. Outcome was assessed objectively by functional sensory recovery testing and by the British Medical Research Council standards. Su bjective outcome was assessed by a questionnaire. Two-point discrimination of less than 10 mm was achieved in 15 of 25 hands. The mean functional sens ory recovery score was 83. Eighteen of 20 patients reported that the functi on of their hands improved after the procedure. Good or excellent results w ere associated with immediate transfer of the nerve, young age, and patient s' attendance to the sensory re-education program after surgery. No differe nces were found between the recovery of ulnar and median nerves. Based on t hese results we suggest that sensory nerve transfer is a simple and reliabl e way of restoring sensibility to the hand with favorably comparable result s over conventional nerve grafting in selected cases. (J Hand Surg 2001;26A :44-51. Copyright (C) 2001 by the American Society for Surgery of the Hand. ).