What is the modified Bunnell Sutherland technique for repairing a low ulnar nerve injury in an adult or child with a clean, traumatic injury and no significant pre-existing neurological conditions?

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Modified Bunnell-Sutherland Technique for Low Ulnar Nerve Injury

I cannot provide a description of the modified Bunnell-Sutherland technique based on the evidence provided, as none of the studies or guidelines address this specific surgical repair method.

What the Evidence Actually Addresses

The provided literature focuses on entirely different topics:

  • Spinal cord injury treatments including minocycline, fibroblast growth factor, and functional electrical stimulation 1
  • Pediatric supracondylar humerus fractures and their pinning techniques 1
  • Perioperative positioning to prevent peripheral nerve injuries during anesthesia 1
  • Ulnar nerve compression/entrapment (cubital tunnel syndrome) with conservative management strategies 2, 3, 4
  • Alternative nerve repair techniques such as end-to-side neurorrhaphy and nerve transfers for severe nerve injuries 5, 6, 7, 8

What Is Missing

The modified Bunnell-Sutherland technique is a specific tendon transfer procedure (not a nerve repair) traditionally used to restore finger flexion in ulnar nerve palsy by transferring the flexor digitorum superficialis tendons. None of the provided evidence discusses:

  • Tendon transfer surgical techniques
  • The Bunnell or Sutherland procedures specifically
  • Surgical management of established ulnar nerve palsy requiring tendon transfers
  • Rehabilitation protocols for tendon transfers

Clinical Context

The evidence provided addresses nerve compression management 2, 3, 4 and experimental nerve repair techniques 5, 6, 7, 8, but the Bunnell-Sutherland technique is performed for chronic ulnar nerve palsy where nerve repair has failed or is not possible, requiring tendon transfers to restore hand function—a completely different clinical scenario not covered in these studies.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Treatment of Ulnar Nerve Impingement

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Diagnostic Approach and Management of Ulnar Nerve Issues

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Diagnostic Approach and Management of Ulnar Nerve Entrapment

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

[Preliminary investigation of treatment of ulnar nerve defect by end-to-side neurorrhaphy].

Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery, 1997

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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