Vascularization of the Ulnar Nerve: Anatomical Feasibility as a Vascularized Nerve Graft for Contralateral C7...

Recent advances in brachial plexus reconstruction have highlighted the potential advantages of vascularized nerve grafts for functional recovery in high-priority nerve injuries. This anatomical study evaluated the extrinsic vascular supply of the ulnar nerve based on the superior ulnar collateral artery (SUCA) in the arm, aiming to assess its feasibility for use as a vascularized nerve graft in contralateral C7 (cC7) transfer procedures. Fifteen adult upper limbs of donated bodies were dissected to delineate the arterial supply, venous drainage of the ulnar nerve, and the anastomotic patterns of these vessels. The SUCA was consistently identified as the dominant longitudinal arterial source to the ulnar nerve in the arm, with consistent anastomoses and reliable venae comitantes in most body donors. The mean SUCA external diameter was 2.0 ± 0.01 mm and mean length to the first neural branch was 76 ± 34 mm, providing an adequate pedicle for free or pedicled transfer. These results confirm the anatomical feasibility of harvesting a vascularized ulnar nerve graft based on the SUCA for cC7 transfer, supporting its potential to enhance nerve regeneration in complex brachial plexus reconstruction.