AIN to Ulnar Nerve Transfer
AIN to ulnar nerve transfer Sydney
For people who have lost function in a part of the body due to nerve damage, nerve transfer surgery may be a good option. In this procedure, a part of a functioning nerve is surgically moved to a new location, in order to help replace the functions of a damaged nerve. This is an advanced and highly technical procedure, but it offers the potential for restoring lost motor and/or sensory function following nerve damage.
Dr. Sungaran is an expert in a variety of nerve transfer procedures. One of the specific types that’s often helpful is known as an AIN to ulnar nerve transfer. This procedure can help to restore hand function in people who have lost it due to nerve damage.
What is the ulnar nerve?
The ulnar nerve is a major nerve of the hand. It arises deep in the shoulder, and is formed from fibers exiting the spinal cord in the neck. As it passes from the shoulder to the hand, it crosses the elbow. This is the nerve that tingles when you “hit your funny bone.” The ulnar nerve carries sensory information from the pinky, half of the ring finger, and the part of the palm on that side of the hand. It also carries motor information to the muscles within the hand, as well as a few muscles of the forearm.
Because the ulnar nerve passes through a narrow tunnel at the elbow, it can become compressed by conditions that cause inflammation of the elbow, such as repetitive stress injuries. Repetitive stress can also cause this nerve to become compressed at the wrist, where it crosses into the hand. In addition, there are other ways that the ulnar nerve can be damaged, like accidents.
When the ulnar nerve isn’t functioning well, it’s difficult to use the hand. Patients may experience weakness of the hand muscles, difficulty coordinating movements of the hand, and tingling or pain in the pinky, side of the ring finger, and side of the palm. They often have a lack of pinch strength, making it difficult to accomplish tasks using that hand. Ulnar nerve injuries can result in a condition called a claw hand deformity, in which the hand becomes stuck in the shape of a claw (with bent fingers).
What is the AIN?
The anterior interosseous nerve, or AIN, is a branch of the median nerve. Along with the ulnar nerve and the radial nerve, the median nerve is one of the three main nerves to the hand. The AIN branches off from the median nerve in the forearm, close to the elbow. It provides both sensory and motor function to parts of the forearm.
What happens during AIN to ulnar nerve transfer?
During a nerve transfer procedure, a neurosurgeon takes parts of a functioning nerve, which is called the donor nerve. The surgeon then connects these parts of the donor nerve to a damaged nerve, which is called the recipient nerve. The transferred part of the nerve will grow into the area served by the damaged nerve, and restore function there.
Sometimes, people are concerned that they will lose function in the areas that the donor nerve provided function to. This may happen to some degree. However, the AIN is much less important to a person’s daily function than the ulnar nerve is. Although there may be a small decrease in strength in the nerves served by the AIN, this is usually not noticeable. However, the ability to use the hand muscles again is usually very noticeable. In addition, because the nervous system is very flexible, the forearm muscles served by the AIN often recover much of their lost function.
The specific technique used for the transfer can make a significant difference in the results. Research has shown very good results from a specific technique known as the supercharged end-to-side (SETS) nerve transfer, in which the end of the donor nerve is passed through the sheath surrounding the recipient nerve and connected to the side of the nerve. This technique produces better results than older techniques like end-to-end nerve transfer, and the results are also better than alternative surgical options like ulnar nerve decompression alone.
The role of motor endplate degeneration
When the ulnar nerve is damaged, it may be able to regenerate itself. However, there’s a limited window of time in which this can occur and result in restored hand function. The connections between the nerve and the muscle, known as the motor endplates, will degenerate over time if they aren’t used.
The ulnar nerve is fairly long, and if it’s damaged at the elbow, it needs to regrow a considerable distance to make it to the hand. By the time this happens, the connections to the muscles may have degenerated, meaning that hand function will not be able to be restored even when the ulnar nerve grows back.
Transferring part of the AIN to the ulnar nerve helps to restore function to the muscles of the hand sooner. In effect, the nerve fibers from the AIN “babysit” the motor endplates in the hand, keeping them functional until the ulnar nerve fibers can regrow. In this way, not only does AIN to ulnar nerve transfer restore function to the hand much sooner, it also ensures that the opportunity to restore function is not lost.
The ulnar nerve fibers may regrow, and then the muscles of the hand will receive signals both from the ulnar nerve and from the AIN. This doesn’t cause any functional problems at all. If the ulnar nerve fibers don’t successfully grow back into the hand, then the hand will still be functional due to the innervation from the AIN.
AIN to ulnar nerve transfer Sydney
AIN to ulnar nerve transfer is a complex procedure, and knowledge of the specific surgical techniques used is crucial. Dr. Sungaran is highly trained in the techniques of microsurgery, and is a recognized expert in the field of nerve transfer surgery. He has even presented research on nerve transfer surgery at the Australian Orthopaedic Association conference. Patients can trust that Dr. Sungaran will perform their nerve transfer procedures at the highest possible level of skill.
If you’re in the greater Sydney area or are willing to travel here for your procedure, we invite you to schedule a consultation with Dr. Sungaran. After examining you and learning about your medical history, he’ll let you know whether AIN to ulnar nerve transfer would be a good option for you. To schedule your appointment at either of our two locations, please contact our front desk staff.
