{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,8,13]],"date-time":"2022-08-13T23:11:06Z","timestamp":1660432266721},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003For a nerve gap, end-to-end neurorrhaphy would either be difficult or would include tension. The use of a nerve graft or conduit could be a solution, but it might compromise the reinnervation. We describe a method for wrist-level ulnar and\/or median long nerve injury by fixing the wrist in the flexion position with K-wire (s) to make possible an end-to-end and tension-free neurorrhaphy.<\/jats:p><jats:p>\n          Patients and Methods\u2003Two patients had wrist-level ulnar nerve injury for 2 and 3 months and nerve gaps of 2.5\u2009cm and 3.5\u2009cm, respectively, after the neuroma excision. K-wires were used to transfix from the radius to carpal bones, in order to keep their wrists in flexion of 45 and 65 degrees, respectively, with which the tension-free end-to-end neurorrhaphy could be achieved. The K-wires were removed in 6 weeks after surgery, and their wrists were kept in the splint for a progressive extension program.<\/jats:p><jats:p>\n          Results\u2003Both patients were noted to have an improved claw hand deformity 4 months after the surgery. The ulnar nerve motor and sensory function could be recovered mostly in the 12-month follow-up. The wrist flexion and extension motion arc both achieved, at least, 150 degree in the 12-month follow-up. There were no complications related to the K-wire fixation.<\/jats:p><jats:p>\n          Conclusion\u2003With the wrist fixed in a flexed position, maintaining a longer nerve gap to achieve a direct end-to-end and tension-free neurorrhaphy would be more likely and safer. Without the use of nerve graft, innervation of the injured nerve would be faster.<\/jats:p>","DOI":"10.1055\/s-0041-1729635","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T23:46:00Z","timestamp":1620690360000},"page":"362-366","source":"Crossref","is-referenced-by-count":0,"title":["Direct End-to-End Neurorrhaphy for Wrist-Level Long Nerve Defect with Fixation of the Wrist in Flexion: Technique Note"],"prefix":"10.1055","volume":"11","author":[{"given":"Chun-Ching","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Taipei Veterans General Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui-Kuang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung-Pan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Taipei Veterans General Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,5,10]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1055\/s-0032-1333316","article-title":"Nerve repair by means of tubulization: past, present, future","volume":"29","author":"P Konofaos","year":"2013","journal-title":"J Reconstr Microsurg"},{"issue":"08","key":"ref2","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1055\/s-0031-1281526","article-title":"Comparisons of outcomes from repair of median nerve and ulnar nerve defect with nerve graft and tubulization: a meta-analysis","volume":"27","author":"M Yang","year":"2011","journal-title":"J Reconstr Microsurg"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1055\/s-0035-1544169","article-title":"Principles of nerve repair in complex wounds of the upper extremity","volume":"29","author":"A M Moore","year":"2015","journal-title":"Semin Plast Surg"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.jhsa.2017.02.017","article-title":"The role of nerve graft substitutes in motor and mixed motor\/sensory peripheral nerve injuries","volume":"42","author":"N Rbia","year":"2017","journal-title":"J Hand Surg Am"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1302\/0301-620X.101B2.BJJ-2018-0839.R1","article-title":"Nerve transfers for peripheral nerve injury in the upper limb: a case-based review","volume":"101-B","author":"J Isaacs","year":"2019","journal-title":"Bone Joint J"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jhsa.2014.04.038","article-title":"Management of ulnar nerve injuries","volume":"40","author":"A Woo","year":"2015","journal-title":"J Hand Surg Am"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.main.2011.04.010","article-title":"Gunshot injuries to the nerves","volume":"30","author":"C Oberlin","year":"2011","journal-title":"Chir Main"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1097\/00000637-199805000-00007","article-title":"A nerve distraction model in the rat","volume":"40","author":"M S Margiotta","year":"1998","journal-title":"Ann Plast Surg"},{"issue":"329","key":"ref9","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1097\/00003086-199608000-00038","article-title":"Effects of external fixation and limb lengthening on peripheral nerve function","author":"M R Makarov","year":"1996","journal-title":"Clin Orthop Relat Res"},{"issue":"07","key":"ref10","doi-asserted-by":"crossref","first-page":"615.e1","DOI":"10.1016\/j.jhsa.2018.09.004","article-title":"Testing of direct neurorrhaphy strain","volume":"44","author":"B S Smetana","year":"2019","journal-title":"J Hand Surg Am"},{"issue":"S 03","key":"ref11","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1016\/j.injury.2008.05.015","article-title":"Current treatment concepts for neuromas-in-continuity","volume":"39","author":"A F Mavrogenis","year":"2008","journal-title":"Injury"},{"issue":"238","key":"ref12","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/00003086-198901000-00038","article-title":"The tension-stress effect on the genesis and growth of tissues. 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