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Lantis KD, Saul K, Schmidt DJ. Short-term effects of running exercise on pinch strength, grip strength, and manual dexterity of the dominant and non-dominant hands. ERGONOMICS 2024:1-11. [PMID: 38647262 DOI: 10.1080/00140139.2024.2344688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 04/13/2024] [Indexed: 04/25/2024]
Abstract
Occupations including first responders and military require manual tasks; therefore changes in hand strength and dexterity could affect performance. We hypothesised that pinch strength, grip strength, and dexterity will change after unloaded and loaded exercise. Twenty-four male (25 ± 4.0 yrs; 86.3 ± 9.3 kg) and 10 female (25 ± 6.0 yrs; 62.1 ± 5.9 kg) participants completed 3 conditions for 5 minutes: (1) no exercise (2) run with no load at 3.0 m/s and (3) run wearing a 9.1 kg belt. Heart rate was different among conditions (p ≤ 0.05). Pinch strength was significantly different for the non-dominant hand after exercise (p = 0.005) for male participants, but not for the dominant hand. Grip strength was significantly different for the non-dominant hand between loaded and unloaded run (p = 0.035) for male participants. Pinch and grip strength did not change after exercise for female participants. Dexterity times were not different after exercise, but female participants were significantly faster (p ≤ 0.039) than male participants.
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Affiliation(s)
- Kristen D Lantis
- Department of Kinesiology, California State University San Marcos, San Marcos, California, USA
| | - Katherine Saul
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Deanna J Schmidt
- Department of Kinesiology, California State University San Marcos, San Marcos, California, USA
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Glaser JJ, Aman M, Böcker AH, Thielen M, Harhaus L. [Nerve Transfers in Peripheral Nerve Lesions]. HANDCHIR MIKROCHIR P 2024; 56:49-54. [PMID: 38316412 DOI: 10.1055/a-2228-7062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Lesions of peripheral nerves of the upper extremities often lead to persistent, serious limitations in motor function and sensory perception. Affected patients suffer from both private and professional restrictions associated with long-term physical, psychological and socioeconomic consequences. INDICATION An early indication for a nerve transfer shortens the reinnervation distance and improves the growing of motor and sensory axons into the target organ to facilitate early mobility and sensitivity. When planning the timepoint of the surgical procedure, the distance to be covered by reinnervation as well as the morbidities of donor nerves must be considered individually. RESULTS Nerve transfers can achieve earlier and safer reinnervation to improve motor and sensory functions after nerve injuries in the upper extremity.
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Affiliation(s)
- Julia Janine Glaser
- Abteilung Handchirurgie, Periphere Nervenchirurgie, Rehabilitation, BG Klinik Ludwigshafen, Germany
| | - Martin Aman
- Abteilung Handchirurgie, Periphere Nervenchirurgie, Rehabilitation, BG Klinik Ludwigshafen, Germany
| | - Arne Hendrik Böcker
- Abteilung Handchirurgie, Periphere Nervenchirurgie, Rehabilitation, BG Klinik Ludwigshafen, Germany
| | - Mirjam Thielen
- Abteilung Handchirurgie, Periphere Nervenchirurgie, Rehabilitation, BG Klinik Ludwigshafen, Germany
| | - Leila Harhaus
- Abteilung Handchirurgie, Periphere Nervenchirurgie, Rehabilitation, BG Klinik Ludwigshafen, Germany
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Lo IN, Yin CY, Huang HK, Huang YC, Wang JP. Outcomes of radiocarpal pinning to facilitate nerve repair in wrist-level ulnar nerve injuries with defect. J Chin Med Assoc 2023; 86:981-984. [PMID: 37729606 DOI: 10.1097/jcma.0000000000001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND The ideal scenario for ulnar nerve repair is primary end-to-end neurorrhaphy in a tension-free environment. However, this could be complicated by soft tissue loss, scarring, and neuroma formation in a delayed injury, creating a nerve defect. With a wrist-level nerve defect, a flexion position can help shorten the nerve gap; however, maintaining the position can be challenging intraoperatively and postoperatively. METHODS Previously, we proposed our method of using a 1.6-mm K wire for radius-lunate-capitate pinning of the wrist in flexion to minimize the nerve gap, thereby facilitating neuroma excision and end-to-end neurorrhaphy in delayed ulnar nerve injury. In this study, we elaborate our method and present our case series. RESULTS From October 2018 to July 2020, five patients (mean age: 48.2 years; mean delay from injury to surgery: 84.6 days; mean follow-up: 17.5 months) were retrospectively reviewed. The mean flexion fixation angle was 52°, and the K wire was removed at an average of 5.1 weeks postoperatively. All patients were followed up for a minimum of 12 months. All patients achieved M4 and S3 or S3+ neurologically (according to the criteria of the Nerve Injuries Committee of the British Medical Research Council). The mean disabilities arm, shoulder, and hand score was 14.1. The mean grasp and pinch strengths were, respectively, 76.8% and 63.6% of the contralateral hand. All wrist range of motion returned to normal within 12 weeks. No complications were noted intraoperatively or postoperatively. CONCLUSION Our study showed that radiocarpal pinning of the wrist in flexion was safe and convenient to minimize the nerve gap and to facilitate end-to-end neurorrhaphy in limited-sized wrist-level ulnar nerve defects.
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Affiliation(s)
- I-Ning Lo
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital Taitung Branch, Taitung, Taiwan, ROC
| | - Cheng-Yu Yin
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Hui-Kuang Huang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Orthopaedics, Chiayi Christian Hospital, Chiayi, Taiwan, ROC
- Chung Hwa University of Medical Technology, Tainan, Taiwan, ROC
| | - Yi-Chao Huang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Jung-Pan Wang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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Costa JQ, Leite MJ, Relvas M, Vieira P, Negrão P, Vidinha V. Ulnar-Sided Upper Extremity Traumatic Wounds: What Should We Expect to Find? J Hand Surg Asian Pac Vol 2023; 28:435-440. [PMID: 37758486 DOI: 10.1142/s2424835523500480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Background: Upper limb traumatic injuries have a significant impact on social and professional life; however, there is still a paucity of studies focusing on the injuries of the ulnar border of the forearm, wrist and hand. Methods: We designed a retrospective single-blinded study, including all patients with deep traumatic wounds affecting the ulnar side of the forearm, wrist or hand, that received surgical treatment from 2006 until 2016. A characterisation of the sample, assessment of concomitant injuries and clinical outcomes, as well as neurological and functional evaluation were performed. Results: We obtained a sample of 61 patients, 69% with injuries affecting the wrist and 90% of patients with a neurological lesion, most frequently of the ulnar nerve lesion (UNL). Concomitant injuries included tendinous lesions, more frequently of the flexor carpi ulnaris (64%) and fractures (13%). And 39% of patients presented an ulnar artery lesion, without significant differences in outcomes regarding the completion of arteriorrhaphy or not. At the end of the 8.6 years follow-up, 34% of patients had no deficits; however, patients with UNL showed worse functional scores and greater risk of sequelae. Besides motor function compromise, sensory deficits were also associated with worst functional outcomes. Conclusions: The UNL subgroup showed important impairment of the first ray, probably related to the level of UNL. Furthermore, besides the implications of the motor sequelae, sensory deficits were also associated with worst functional scores. Due to the high percentage of neurovascular and tendinous lesions in ulnar-sided upper extremity wounds, the authors recommend surgical exploration of these lesions. Level of Evidence: Level IV (Therapeutic).
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Gross JN, Dawson SE, Wu GJ, Loewenstein S, Borschel GH, Adkinson JM. Outcomes after Anterior Interosseous Nerve to Ulnar Motor Nerve Transfer. J Brachial Plex Peripher Nerve Inj 2023; 18:e1-e5. [PMID: 36644673 PMCID: PMC9833888 DOI: 10.1055/s-0042-1760097] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/07/2022] [Indexed: 01/13/2023] Open
Abstract
Background Ulnar nerve lesions proximal to the elbow can result in loss of intrinsic muscle function of the hand. The anterior interosseous nerve (AIN) to deep motor branch of the ulnar nerve (DBUN) transfer has been demonstrated to provide intrinsic muscle reinnervation, thereby preventing clawing and improving pinch and grip strength. The purpose of this study was to evaluate the efficacy of the AIN to DBUN transfer in restoring intrinsic muscle function for patients with traumatic ulnar nerve lesions. Methods We performed a prospective, multi-institutional study of outcomes following AIN to DBUN transfer for high ulnar nerve injuries. Twelve patients were identified, nine of which were enrolled in the study. The mean time from injury to surgery was 15 weeks. Results At final follow-up (mean postoperative follow-up 18 months + 15.5), clawing was observed in all nine patients with metacarpophalangeal joint hyperextension of the ring finger averaging 8.9 degrees (+ 10.8) and small finger averaging 14.6 degrees (+ 12.5). Grip strength of the affected hand was 27% of the unaffected extremity. Pinch strength of the affected hand was 29% of the unaffected extremity. None of our patients experienced claw prevention after either end-to-end ( n = 4) or end-to-side ( n = 5) AIN to DBUN transfer. Conclusion We conclude that, in traumatic high ulnar nerve injuries, the AIN to DBUN transfer does not provide adequate intrinsic muscle reinnervation to prevent clawing and normalize grip and pinch strength.
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Affiliation(s)
- Jeffrey N. Gross
- Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Steven E. Dawson
- Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Gerald J. Wu
- Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Scott Loewenstein
- Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Gregory H. Borschel
- Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Joshua M. Adkinson
- Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, United States,Address for correspondence Joshua M. Adkinson, MD Indiana University Department of SurgeryDivision of Plastic Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Indianapolis, IN 46202United States
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Bertelli JA, Hill EJR, Arami A, Seltser A. Bilateral Ulnar Nerve Injury in the Wrist: Comparison of First Webspace Muscle Reconstruction by Opponens Nerve Transfer in the Right Hand Versus Direct Ulnar Nerve Repair in the Left Hand. Hand (N Y) 2023; 18:NP5-NP9. [PMID: 35499179 PMCID: PMC9806529 DOI: 10.1177/15589447221085665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We report a case of a bilateral glass injury to the wrist with transection of flexor tendons and the ulnar nerve and artery in a 60-year-old male patient. Two days after his accident, we repaired all divided structures, and on the right hand, we added the transfer of the opponens motor branch to the deep terminal division of the ulnar nerve aimed at first dorsal interosseous and adductor pollicis muscle reinnervation. After surgery, the patient was followed over 24 months. Postoperative dynamometry of the hand, which included grasping, key-pinch, subterminal-key-pinch, pinch-to-zoom, and first dorsal interosseous muscle strength, indicated recovery only in the nerve transfer side.
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Arami A, Bertelli JA. Effectiveness of Distal Nerve Transfers for Claw Correction With Proximal Ulnar Nerve Lesions. J Hand Surg Am 2021; 46:478-484. [PMID: 33341296 DOI: 10.1016/j.jhsa.2020.10.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/11/2020] [Accepted: 10/01/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate claw deformity correction following anterior interosseous nerve (AIN) end-to-end transfer to the deep motor branch of the ulnar nerve (DMBUN) in high ulnar nerve injuries. METHODS Eleven patients were retrospectively evaluated for metacarpophalangeal joint hyperextension and proximal interphalangeal joint extension lag in the fourth and fifth digits following ulnar nerve injury adjacent or proximal to the elbow, who underwent AIN end-to-end transfer to the DMBUN. RESULTS Patients underwent surgery an average of 5 months following injury (range, 2-9 months) and were followed for an average of 19 months after surgery (range, 12-30 months). At the last follow-up, clawing was observed in all patients, with proximal interphalangeal joint extension lag averaging 46.8° (SD, ±20°) in the fourth digit and 57.7° (SD, ±12°) in the little finger. CONCLUSIONS None of our patients experienced claw correction after AIN end-to-end transfer to the DMBUN. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.
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Affiliation(s)
- Amir Arami
- Department of Hand Surgery, Sheba Medical Center, Affiliated to Sackler School of Medicine, Tel Aviv University, Ramat Gan, Israel.
| | - Jayme Augusto Bertelli
- Center of Biological and Health Sciences, Department of Neurosurgery, University of the South of Santa Catarina (Unisul), Tubarão, SC, Brazil; Department of Orthopedic Surgery, Governador Celso Ramos Hospital, Florianópolis, SC, Brazil
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