الفهرس 
Ulnar Nerve PalsyOnly 14 pages are availabe for public view
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Abstract
Peripheral nerve injuries to the upper extremity are common and have a serious effect on patients’ lives. Ulnar nerve injury (UNI), as opposed to median and radial nerve injuries, Specifically, injuries at or above the elbow level exhibit the worst prognosis when managed with primary neurorrhaphy or autogenous nerve grafts. Traumatic UNI is a social and economic concern because patients’ decreased productivity at work during this time could cost them their jobs. Tendon transfers, which enable active controlled mobility, are the only treatment option for ulnar nerve injuries that go untreated. Tendon transfers are intended to fix the claw deformity and regain the hand grip. Numerous experimental studies ascertained the functionality of tendon transfer surgical procedures; however, no previous clinical trial compared ZLP and ECRL techniques. In this study, we compared the functional outcomes of tendon transfer in hand clawing using Zancolli Lasso technique Versus Extensor Carpi Radialis Longus Transfer. The study included 20 patients with ulnar claw hand deformity who were divided into two groups, A and B, each with 10 individuals. While Brand’s ECRL transfer was used to address group B patients, the Zancolli lasso approach of tendon transfer was used to manage group A patients. Over 12 Months, the patients were closely followed up to trace the initial clinical signs of claw deformity correction, hand grip strength and HAT score. The Operative time for group A ranged from 50 to 70 minutes, while group B ranged from 96 to 120 minutes. The initial clinical signs of recovery were detected from 3 to 6 months for both groups, the Mean + SD of postoperative hand grip for group A was 28.40 + 1.65, slightly lowered than group B showing 34.40 + 2.12. This was statistically significant with a P value of <0.001. Regarding HAT score, group A ranged from 60 to 82 preoperatively which was lowered to 33 to 49 postoperatively, while group B ranged from 65 to 90 preoperatively, and became 19-32 postoperatively. This reflects patient own satisfaction with the ultimate statistically significant results tipping the scales towards group B. The resting position of the hand witnessed great difference postoperatively. group A mean + SD for MCP joint resting flexion angle was 34.10 + 5.72 whereas group B showed 36.0 + 7.33. PIP joint also shared the same improvement with 78.0 + 4.69 for group A and 78.70 + 4.92 for group B. Regarding group A, the active range of motion of the MP joint flexion of the medial 2 fingers was between 30 and 50 degrees preoperatively before considerably improving to between 74 and 90 degrees after surgery. While the active range of motion of the medial 2 fingers’ MCP joint extension ranged from 18 to 45 degrees before surgery, it drastically decreased to 10 to 14 degrees afterward. Regarding group B, the preoperative active range of motion for the MCP joint flexion of the medial 2 fingers ranged from 28 to 50 degrees, and it considerably improved to 68 to 90 degrees after surgery. While the active range of motion of the medial 2 fingers’ MP joint extension ranged from 16 degrees to 43 degrees prior to surgery, it drastically decreased to 10 to 15 degrees after surgery. As regard group A, Active range of motion of PIP joint flexion of medial 2 fingers ranged from 74 degree to 90 degree preoperatively, significantly improved to 60 to 82 postoperatively. While active range of motion of PIP joint extension of medial 2 fingers ranged from 10 degree to 14 degree preoperatively, significantly lowered to 4 to 11 degrees postoperatively. As regard group B, Active range of motion of PIP joint flexion of medial 2 fingers ranged from 68 degree to 90 degree preoperatively, significantly improved to 65 to 84 postoperatively. While Active range of motion of PIP joint extension of medial 2 fingers ranged from 10 degree to 15 degree preoperatively, significantly lowered to 4 to 10 postoperatively.