A Pedicled Vascularized Ulnar Nerve Graft Based on the Epineurial Vascular Supply: A Case Report

Vascularized ulnar nerve transfer has been employed as a salvage procedure in reconstruction of brachial plexus injuries and of extensive defects of the median nerve. The earliest technique—two-stage pedicled ulnar nerve graft transfer[1]—has been replaced by microvascular methods, which involve harvesting a segment of the ulnar nerve as a flap nourished directly either by the superior collateral ulnar artery[2] [3] [4] or by the ulnar artery.[5] Birch at al,[4] describing a large series of patients with brachial plexus injuries, mention an epineurium-based ulnar nerve graft proposed by Narakas. Few details of the technique and of the results were given. The following case report describes a technique of pedicled ulnar nerve transfer for median nerve reconstruction, which might be analogous to that used by the Birch et al for brachial plexus reconstruction.

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