A Unique Case of Bilateral High Ulnar Nerve Laceration

Abstract

High ulnar nerve injuries are now commonly treated with a distal nerve transfer, in which the anterior interosseuos nerve to pronator quadratus is coapted to the deep ulnar nerve motor branch. Herein, the authors describe a case of bilateral ulnar nerve laceration that provides an opportunity to directly compare two operative techniques on different extremities of the same patient. The patient sustained bilateral ulnar nerve injuries 6 cm superior to the medial epicondyle. The right ulnar nerve was proximally repaired with primary neurorraphy and a distal motor nerve transfer. The left ulnar nerve underwent primary nuerorraphy without a nerve transfer because the median nerve was mistakenly tied off to control bleeding. Physical examination and nerve conduction studies two years postsurgical intervention demonstrated an undeniable difference in cosmesis and function. The clinical findings suggest a superior result with a combined primary neurorraphy and a distal nerve transfer compared with a primary neurorraphy alone.