Anterior Interosseous to Ulnar Motor Nerve Transfer 2 Mackinnon SE1 Yee A1 February 4, 2014Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.Injury to the ulnar nerve results in clawing of the hand due to lost of ulnar intrinsic hand muscles, lost of ulnar-innervated wrist/finger flexion, and numbness/pain within the ulnar nerve territory of the hand. To prevent clawing and reconstruct the ulnar intrinsic hand muscles, the anterior interosseous to ulnar motor nerve transfer is an available option. This involves transferring the distal pronator quadratus branch of the anterior interosseous nerve to the fascicular motor component of the ulnar nerve. This patient had an ulnar nerve injury following two ulnar nerve transpositions and reported pain and motor deficit immediately following surgery. He presented to our institution eight months post-injury and an end-to-end nerve transfer was elected due to the electrodiagnostic findings of fibrillations and no motor unit potentials by that time point. A Guyon's canal release, flexor digitorum profundus tenodesis for grip strength, and second revision ulnar nerve transposition was performed. This video includes details on the Guyon's canal release and anterior interosseous to ulnar motor end-to-end nerve transfer.Keywords: hand functiondeep motor branch of ulnar nerveanterior interosseous nerveinterfascicular dissectionnerve transferulnar nerveGuyon's canal releasenerve injury You must login to view the full article and extended video on this page. Standard Edition Table of Contents- Slow down- Frustration00:00:00 - Introduction00:00:15 - Orientation / Incision / Distal Exposure00:00:37 - Identifying Guyon's Canal and Distal Antebrachial Fascia00:01:19 - Releasing Guyon's Canal00:02:16 - Exposing the Tendinous Leading-edge of the Hypothenar Muscles00:02:50 - Releasing the Hypothenar Muscles and Deep Motor Branch of Ulnar Nerve00:03:50 - Proximal Exposure00:05:18 - Identifying the Pronator Quadratus with the Anterior Interosseous Nerve and Vessels00:05:46 - Dividing the Pronator Quadratus to Identify the Donor AIN Nerve Branches00:06:47 - Exposure of the Ulnar Nerve00:07:33 - Identifying the Motor Component of Ulnar Nerve and Interfascicular Dissection00:08:19 - Confirming (Distal) the Identification of the Motor Component of Ulnar Nerve (Proximal)00:09:08 - Proximal Interfascicular Dissection of the Ulnar Nerve00:09:43 - Dividing the Donor AIN Distal and Recipient Ulnar Motor Component Proximal00:10:44 - Anterior Interosseous to Ulnar Motor Nerve Transfer You must login to view the full article and extended video on this page. 5 Comments Javier Garcia 7th October 2016 Every video I see from you I cannot restrain from saying thank you so much. You are contributing a great deal to the surgical community and patients worldwide. Greetings from Barcelona. Log in to Reply | Andrew Yee 7th October 2016 Javier, thank you for the kind comments and hope you enjoy our new video platform. Andrew Log in to Reply | SHULIANG XING 9th October 2016 Hi, Andrew. Great job! Shuliang Log in to Reply | Andrew Yee 9th October 2016 Thanks Shuliang, hope all is well on your end. Log in to Reply | Kheireddine Chakhchoukh 31st March 2017 Thank you very much.. that is amazing and beautiful work. I loved it Log in to Reply | Leave a Comment Cancel replyYou must be logged in to post a comment.