Dr. Sharoff Lokesh Mohan
Orthopedician and Traumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I had carpal tunnel, radial and ulnar nerve surgery. A tumor was removed from my elbow on the ulnar nerve. Then my two little fingers have no feeling and are completely curled in along with my thumb. For this, my surgeon advised nerve transplant surgery. When I went for a second opinion, nothing was abnormal with the nerve conduction test, EMG test, and MRI. Now my surgeon has changed his opinion to electronic shock therapy. It has to be done three times a week for six weeks. Also, he is not sure about the outcome. I have constant pain, burning, tingling and sometimes swelling in my elbow and hand. It affects my daily life activities as well as my job. My surgeon also said that my arm muscles are weak to go for surgery. What shall I do? Is there anything to do with this issue? Or am I stuck with my curled fingers?
Hi,
Welcome to icliniq.com.
Getting a tumor removed off the ulnar nerve from the elbow will take at least six months for the nerve to regenerate the sensations till down your little finger. Getting tingling and burning sensations are good as this is a sign of nerve regeneration. You should take medications to help your nerve regenerate. Medicines like vitamin B12 and Pregabalin will help. Vitamin C medicines of 500 mg twice a day will also help. The important thing from your side as a patient is to keep the fingers supple, massage them, and move them every day. Do not allow for contractures to develop. You can wear a carpenter splint for the ring and little finger or a thumb spica splint for short durations intermittently throughout the day and while sleeping. You can also try a reverse knuckle bender splint. Shock therapy is a good option to help your nerve regenerate and keep muscle contraction to occur. The important thing is that no one can guarantee nerve regeneration. If it does not regenerate then there are muscle transfer options available. For that, we need to see which muscles are functioning and then transfer those muscles based on your daily needs. It is really a slow process and sometimes, it can take two to three years also. Muscle transfer is a good option. Once it is confirmed that the nerve has stopped regenerating or it can also be complemented now. But, that requires a thorough examination of each muscle of the forearm and hand before advising anything. Muscle lengthening is another option to help straighten your finger, but the muscles need to be functioning for this surgery.
Preventive measures
Patient's Query
Hello doctor,
Sorry, I have not mentioned the clear history. It has been three years now since I had ulnar nerve surgery and six months since I had radial nerve surgery. I have completed eight weeks of physical therapy and the therapist has also recommended nerve transfer surgery. I have been wearing a splint for my fingers and hand for the past six months. My surgeon now says that the muscles are too weak for transfer surgery. What would make my muscles so weak if there was not a problem? Why do not any of the tests show there is a problem? I feel like I have lost everything. Please help.
Hi,
Welcome back to icliniq.com.
Even if the muscles of the forearm are weak and eventually do not develop then there is always an option of a free muscle transfer from your leg. So, do not worry. We should first try to develop the muscles of the forearm. If not possible then a free muscle from your leg can be used to get the movements of your hand back. This option will always be available and do not think that all is lost.
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Orthopedician and Traumatology
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