Free Vascularized Ulnar Nerve Flap in Total Brachial Plexus Injury—The Chang Gung Experience

Cheyenne Wei-Hsuan Sung; Tommy Nai-Jen Chang; David Chwei-Chin Chuang; Johnny Chuieng-Yi Lu

doi:10.1055/s-0045-1813711

Seminars in Plastic Surgery, Table of Contents

Semin Plast Surg
DOI: 10.1055/s-0045-1813711

Review Article

Free Vascularized Ulnar Nerve Flap in Total Brachial Plexus Injury—The Chang Gung Experience

Authors

Cheyenne Wei-Hsuan Sung

¹Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
Tommy Nai-Jen Chang

¹Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
David Chwei-Chin Chuang

¹Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
Johnny Chuieng-Yi Lu

¹Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan

Abstract

In total brachial plexus injuries, the demand to restore multiple functions of the injured limb is restrained by the limited number of donor nerves for neurotization. The restoration of hand function is often considered the holy grail in total brachial plexus reconstruction. The strategy to use the free vascularized ulnar nerve flap (VUNF) to reestablish both motor function and finger-like sensation in the hand as a one-stage procedure is preferred. The strategy requires harvest of the ulnar nerve as a free flap, microsurgical anastomosis of the perfusing vessels, and coaptation of the ulnar nerve graft to the proximal available donor nerves (ipsilateral C5 or contralateral C7) and distal selected targeted nerve. This chapter is focused on (1) the physiology behind the vascularized nerve, (2) the history of the vascularized nerve, and (3) the application of the VUN as a free flap (VUNF) in total brachial plexus palsy.

Keywords

vascularized ulnar nerve graft - free vascularized ulnar nerve flap - total brachial plexus injury - contralateral C7

Full Text

References

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