Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
I Had A Decompression Of The Of The Ulnar Nerve And An Anterior Interosseous Nerve Transfer
Question: Hello Earlier this year I had a decompression of the ulnar nerve and an Anterior interosseous nerve transfer for ulnar nerve in the forearm. Sadly my ulnar nerve went through a degeneration and the motor end plates atrophied in my right hand. I am now currently 13 week's post surgery and I have been researching many thing's for nerve regeneration and one of them is a low dose of Tacrolimus. It has been used for limb transplants with good results regarding peripheral nerve regeneration but is not so much used just for peripheral nerve regeneration on it's own. Would a short course of Tacrolimus be safe compared to the immunosuppressant dose used for transplant patient's?
Brief Answer:
Low dose tacrolimus is not liekly to help much.
Detailed Answer:
Hello,
Thanks for posting your query.
Your ulnar nerve is degenerated and even after 13 weeks of surgery the signs of recovery are not there. In such a case use of Tacrolimus is not likely to help much. It is used in transplant cases immediately after the surgery and not at later stages. There are no studies available that support its use after 13 weeks of surgery to help in nerve regeneration.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Wishing you good health.
Regards.
Dr. Praveen Tayal.
Low dose tacrolimus is not liekly to help much.
Detailed Answer:
Hello,
Thanks for posting your query.
Your ulnar nerve is degenerated and even after 13 weeks of surgery the signs of recovery are not there. In such a case use of Tacrolimus is not likely to help much. It is used in transplant cases immediately after the surgery and not at later stages. There are no studies available that support its use after 13 weeks of surgery to help in nerve regeneration.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Wishing you good health.
Regards.
Dr. Praveen Tayal.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Yes Dr I have read the studies but no I have not seen it as in used 13 week's after surgery. Could it have been beneficial if used straight after surgery? What are other ideal methods for nerve regeneration, I have heard that Melatonin is apparently suppose to help and lazer therapy is too. Why does tacrolimus promote nerve regeneration for transplant patient's? Wouldn't it do the same action if used for someone like me who is waiting for reinnervation of the ulnar nerve?
Brief Answer:
Details below.
Detailed Answer:
Hello.
Thanks for writing again.
The studies available show starting the use of tacrolimus within 7 days of surgery and in increases the axonal regeneration. But any clinically significant improvement has not been documented in humans.
If used straight after surgery it might have helped but the extent of improvement cannot be predicted.
Melatonin and lazer therapy also can help to some extent but the extent of effect is only mild. In your case all these agents are not likely to help you much.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Details below.
Detailed Answer:
Hello.
Thanks for writing again.
The studies available show starting the use of tacrolimus within 7 days of surgery and in increases the axonal regeneration. But any clinically significant improvement has not been documented in humans.
If used straight after surgery it might have helped but the extent of improvement cannot be predicted.
Melatonin and lazer therapy also can help to some extent but the extent of effect is only mild. In your case all these agents are not likely to help you much.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Why is that Tacrolimus only helps straight after surgery I would have thought that it can help at any time given the effect it has on Axonal regeneration? The lazer therapy and Melatonin are only mild due to the distance of regeneration but I had an anterior interosseous nerve transfer to the Ulnar nerve motor component done which should soon be taking place as nerve transfers are suppose to diminish waiting times while the native axons regenerate to the hand. This still hasn't worked though and I'm not sure how long it is suppose to take to work. Can growth hormone assist with nerve regeneration?
Brief Answer:
Chances of regeneration are better immediately after injury.
Detailed Answer:
The chances of nerve regeneration and the healing is faster just after the surgery as the nerve ends are fresh at that time. The chances of axonal regeneration are better if the surgery is done as soon as possible after the injury. Nerve transfer diminishes the waiting time and increases the chances of regeneration but the nerve has to regenerate on its own. The drugs are only helping agents. If the nerve is not regenerating or growing then the additional medicines including growth hormone cannot start its growth.
We can only hope for your early recovery. Continue with the physiotherapy so that muscle tone is maintained.
Regards.
Chances of regeneration are better immediately after injury.
Detailed Answer:
The chances of nerve regeneration and the healing is faster just after the surgery as the nerve ends are fresh at that time. The chances of axonal regeneration are better if the surgery is done as soon as possible after the injury. Nerve transfer diminishes the waiting time and increases the chances of regeneration but the nerve has to regenerate on its own. The drugs are only helping agents. If the nerve is not regenerating or growing then the additional medicines including growth hormone cannot start its growth.
We can only hope for your early recovery. Continue with the physiotherapy so that muscle tone is maintained.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My nerve was not severed in the ulnar nerve it was only decompressd.. The nerve transfer from the AIN nerve to the Ulnar nerve would have been the only severing as it had to have an anastomosis done. Ideally that would have been good however it took a month to diagnose and then find a surgeon and see when the date is available so that took 10weeks all together. What can be done for the nerve regeneration to be made quicker? My hand muscles have already atrophied due to the Ulnar nerve not sending a signal to the them. Can the muscle wastage come back once the ulnar nerve signal has made it to the hand?
Brief Answer:
Methylcobalamin supplements can help.
Detailed Answer:
Hello.
Compression of the nerve also cuts off the blood supply and can cause difficulty in nerve regeneration if it has been compressed for too long.
You can have multivitamin supplements and methylcobalamin supplements to help in nerve regeneration. The muscle wastage can improve once the nerve signal reaches the hand. Please do not worry.
Regards.
Methylcobalamin supplements can help.
Detailed Answer:
Hello.
Compression of the nerve also cuts off the blood supply and can cause difficulty in nerve regeneration if it has been compressed for too long.
You can have multivitamin supplements and methylcobalamin supplements to help in nerve regeneration. The muscle wastage can improve once the nerve signal reaches the hand. Please do not worry.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ideally that would have been great to have had the ulnar nerve decompression straight away sadly it is an elective surgery and takes a little time. So my hypotheaner muscle can come back? as I feel it is completely wasted and has been for four months all together.
Brief Answer:
Yes the muscle can come back.
Detailed Answer:
The hypothenar muscles can come back even after wasting once they get the nerve signals. Do continue with the physiotherapy.
Regards.
Yes the muscle can come back.
Detailed Answer:
The hypothenar muscles can come back even after wasting once they get the nerve signals. Do continue with the physiotherapy.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is there a certain amount of time to get them back? I have not had them for about four months. I can't do much about the hand excersises as I need the ulnar nerve to do many.
Brief Answer:
You can get them back even after one year.
Detailed Answer:
Muscles can develop mass even after one year of wasting. As soon as it gets a nerve signal, the muscle fibers start responding and repeated contraction and relaxations help in regaining the muscle mass.
Regards.
You can get them back even after one year.
Detailed Answer:
Muscles can develop mass even after one year of wasting. As soon as it gets a nerve signal, the muscle fibers start responding and repeated contraction and relaxations help in regaining the muscle mass.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
