الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
High ulnar nerve palsy results in profound hand disability, where direct repair or grafting usually restore protective sensation, but recovery of useful intrinsic motor function is uncommon. Therefore, this study aimed to assess the clinical and functional patients’ outcomes of reverse end-to-side AIN to ulnar motor nerve transfer combined with proximal direct microsurgical repair or nerve grafting with anterior nerve transposition in reconstruction of high ulnar nerve palsy. This study was carried out as a prospective observational analysis of patients with high ulnar nerve palsy during the period from June 2015 to March 2017. Twelve patients (8 with high ulnar nerve neurotemetic injury and 4 with recent severe cubital tunnel syndrome) underwent reverse (supercharge) end-to-side AIN to ulnar motor nerve transfer combined with proximal direct microsurgical repair or nerve grafting with anterior nerve transposition in neurotmetic nerve injuries, or combined with decompression, external neurolysis and anterior nerve transposition in severe cubital tunnel syndrome. Improvement of grip and pinch strengths, recovery of intrinsic motor power (adductor pollicis, interossei and abductor digiti minimi), improvement of clawing of ring and little fingers and complications were investigated as outcome measures. Arabic quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) score was applied to assess the functional outcomes. Patients were followed up for an average period of 8.8 (6-18) months. Postoperative adductor pollicis, interossei and abductor digiti minimi motor power; key pinch strength; grip strength; and DASH scores improved significantly from preoperative measurements in all patients (p<0.05). No patients demonstrated weakness of pronation postoperatively. Patients with cubital tunnel syndrome reported better outcomes than those with complete neurotmetic high ulnar nerve injuries.
from this study, one can conclude that
• Reverse end-to-side nerve transfer of distal AIN to distal ulnar motor nerve combined with proximal procedure can achieve better clinical and functional outcomes in patients with high ulnar nerve palsies.