3rd Webspace to Sensory Component of Ulnar Nerve Transfer and PCM to DCU Nerve Transfer 4 Mackinnon SE1 Yee A1 August 22, 2013Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.Sensory nerve transfers are an available option for restoring sensation to critical deinnervated territories. Multiple strategies exist for restoring sensation, which include end-to-end nerve transfers for critical territories and end-to-side nerve transfers for non-critical territories. For sensory deficits in the ulnar nerve, the 3rd webspace fascicle from the median nerve can be utilized as a donor to reinnervate the ulnar territory of the hand, also known as the median to ulnar sensory nerve transfer. In this case, the patient suffered a traumatic ulnar nerve injury that was referred to our institution several years following for neuropathic pain. This was the patient's chief compliant and became the management priority. An ulnar nerve transection, proximal crush, cautery cap, and proximal transposition were elected. While this resolves the neuroma component of pain, there can still exist a hyperalgesia component, which distal nerve transfers would resolve through reinnervation. This video details the 3rd webspace to sensory component of the ulnar (end-to-end) nerve transfer. The distal 3rd webspace nerve was end-to-side transferred to the sensory component of the median nerve. Additionally, the palmar cutaneous branch of median nerve was (end-to-end) transferred to the dorsal cutaneous branch of ulnar nerve.Keywords: third webspace fasciclesensory end-to-side nerve transfermedian nerveinterfascicular dissectionulnar nerveGuyon's canal releasesensory nerve transfernerve injury Standard Edition Table of Contents- Slow down- Frustration00:00:00 - Introduction00:00:15 - Orientation / Incision / Exposure00:01:07 - Guyon's Canal Release and Identifying the Sensory / Motor Components of Ulnar Nerve00:02:16 - Carpal Tunnel Release and Exposure of Median Nerve00:02:56 - Identifying the Palmar Cutaneous Branch and 3rd Webspace Fascicle of Median Nerve00:03:25 - Neurolyzing the 3rd Webspace Fascicle from the Median Nerve00:05:10 - Exposure of Ulnar Nerve00:05:40 - Identifying and Neurolyzing the Dorsal Cutaneous Branch of Ulnar Nerve00:06:03 - Identifying the Sensory Component of Ulnar nerve00:06:10 - Interfascicular Dissection of the Ulnar Nerve00:06:32 - Confirming (Distal) the Identification of the Sensory Component of Ulnar Nerve (Proximal)00:07:24 - Dividing the Ulnar Nerve Proximally00:07:34 - Dividing the 3rd Webspace Fascicle Distally00:07:54 - Distal 3rd Webspace to Sensory Component of Median (End-to-side) Nerve Transfer00:08:52 - Dividing the Palmar Cutaneous Branch of Median Nerve Distally00:09:19 - Neurolyzing the Sensory Component of Ulnar Nerve00:10:52 - 3rd Webspace to Ulnar Sensory Nerve Transfer and PCM to DCU Nerve Transfer You must login to view the full article and extended video on this page. Leave a Comment Cancel replyYou must be logged in to post a comment.