Can I get muscle transfer after ulnar nerve injury?

Question

Hello doctor,

Earlier this year, approximately five months ago, I was diagnosed with ulnar nerve entrapment at the right elbow. Sadly, I declined rapidly and lost all my hypotheaner and some of my lumbericals in a matter of six weeks.

I was operated on exactly 14 weeks ago, where I had a decompression of the ulnar nerve and an anterior interosseous nerve transfer to the motor component of the ulnar nerve so that the nerve axons would reach my hand more quickly.

I still have no improvement, and I wanted to ask if it is possible to transfer muscle to fill in the hand?
Will this protect my nerves in the hand?
Would it be too soon to be considering this operation?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your query is genuine, and I am extremely sorry to learn about your problems. To answer, let me explain to you how a nerve grows. It takes one month of latency, and later nerve grows at 1 mm (one millimeter) per day. Even though the nerve might reach your muscle, for bulk to improve, it takes another few months.

For one to determine if the nerve signals have improved, you can get an electromyography (EMG) to see for any improvement. Decompression will improve sensation very fast and then power. But for muscle bulk, it usually takes a while for muscle transfer to be suitable.

In case you have any form of weakness and never want to fill up a cosmetic defect such as hypothenar flatness, one can consider fat grafting. If the bulk does not improve after six months.

I would advise you to wait, as it usually takes longer than 14 weeks. If you want to see and have proof of progress, go for EMG. No muscle transfer as per my advice for now, if you are not having any weakness.

I hope this helps.

Thank you.