Ulnar nerve group fascicular repair

Any deficit attributable to the ulnar nerve with an associated laceration or injury along the course of the nerve.

High-energy injuries associated with blunt trauma and no appreciable recovery on examination.

Prior nerve repairs with no appreciable recovery on examination after 6 months.

See Chapter 65 for pertinent examination findings.

In patients with prior repair, check for a Tinel sign or symptomatic neuroma formation.

Because of the communicating branches between the median and ulnar nerve (i.e., Martin-Gruber and Riche-Cannieu), patients may have preserved motor function in the presence of an injury. Despite these connections, sharp lacerations should undergo direct repair.

X-rays are used to detect fractures or dislocations that may contribute to ulnar nerve injury/palsy.

Electromyography and nerve conduction studies are useful to detect the presence or absence of sensory and/or motor deficits, as well as denervation/reinnervation based on increased latencies, decreased amplitudes, and/or the presence of fasciculations or fibrillations within the muscle upon needle insertion during this examination.