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Spinal Nerves: Plexus I

Spinal Nerves: Plexus I

Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...

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Inducing Ulnar Nerve Function while Eliminating Claw Hand and Reducing Chronic Neuropathic Pain.

Christian A Foy¹, William F Micheo², Damien P Kuffler²

¹Section of Orthopedic Surgery, Institute of Neurobiology, Medical School, University of Puerto Rico, San Juan, Puerto Rico.

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Summary

A novel surgical technique successfully repaired severe ulnar nerve gaps, restoring hand function and eliminating chronic pain and finger clawing in a gunshot injury patient.

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Area of Science:

Regenerative Medicine
Neurosurgery
Peripheral Nerve Repair

Background:

Ulnar nerve injuries can cause debilitating finger clawing, grip weakness, and chronic neuropathic pain.
Restoring function and alleviating pain after significant ulnar nerve gaps is challenging.

Observation:

A 25-year-old patient with a 5.7-month-old gunshot wound presented with three 10 cm ulnar nerve gaps.
The patient experienced severe finger clawing and escalating neuropathic pain.

Findings:

A novel technique using sural nerve grafts within a PRP-filled collagen tube bridged the nerve gaps.
Axonal regeneration occurred across all gaps, restoring S4 sensitivity, 4mm two-point discrimination, M4 motor function, and full range of motion.
Finger clawing was eliminated, and neuropathic pain reduced from 7/10 to 0/10, with sustained relief for over 3.75 years.

Implications:

This technique shows promise for treating extensive ulnar nerve defects.
It offers potential for functional recovery and pain reduction in severe nerve injuries.
Further research is needed to confirm the role of platelet-rich plasma (PRP).