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Is It Possible To Rebuild The Lumbericals And The Hypotheaner Muscles Of The Hand Again?

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Posted on Wed, 23 Nov 2022
Question: Hello Dr I need to know is it possible to rebuild the lumbericals and the hypotheaner muscles of the hand again? as I had an ulnar nerve entrapment and a very bad one where I deteriorated rapidly. My whole hypotheaner has wasted not just a little but all. I am 13 week's post now. Can they be built again once a nerve connection is there? Or would it be better to have cosmetic muscle implants?
doctor
Answered by Dr. Olsi Taka (2 hours later)
Brief Answer:
It is possible.

Detailed Answer:
I read your question carefully and I understand your anxiety regarding regaining the lost function.

If the nerve surgery was successful it is certainly possible to regain the lost muscle bulk. The muscle fibers are there they just haven't had any stimulation by the nerve for a long time hence undergoing atrophy. The longer the wait between nerve damage and surgery the more marked the atrophy is.
Naturally it is not a process which will happen over night. While the surgery took place 13 weeks ago it will take some time for the joined nerve fibers to create new synapses between them. The surgery links them mechanically but the development of synapses with chemical interaction in them takes time. Also that process is not perfect the new synapses may not be able to completely replace the function of the old ones. However at your young age there is a strong ground to be optimistic that there will be a satisfactory result. Ones the new synapses are formed which will take signals to the atrophied muscle the muscle bulk will start to develop. So as you can see it is a process with several stages which will take some time, may take up to a year. For that reason I wouldn't consider muscle implants or other interventions yet, only physical therapy at least for a year.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (9 hours later)
Yes Dr the Decompression was successful and I even had a nerve transfer done. The anterior interosseous nerve was sutured to the motor component of the ulnar nerve to reach the hand quicker. See I was diagnosed with Ulnar nerve entrapment and I declined very quickly, 6weeks and my hand atrophied from when I noticed symptoms. So the muscle fibre is still there even though my hypotheaner has completely atrophied? So I should not get the reconstructive hand Surgery for implants just yet? My hand muscles have been deinnervated for four month's now. Will I still have time to build them once I get the ulnar nerve signal?
doctor
Answered by Dr. Olsi Taka (6 hours later)
Brief Answer:
Thank you for the additional info, same advice as before.

Detailed Answer:
Thank you for the additional information. My opinion remains more or less the same. It is a gradual process which needs time as I explained, but there is certainly hope for improvement, so I would wait up to a year before considering other interventions.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (1 hour later)
Yes I understand Dr it's just hard to be optimistic in this. I also take Mega doses of Methylcolbamin Vit E VD2 Alpha lipoic acid PQQ Lion's Maine Quercetin. I have also had Stem cells done Aidpose to be exact, I do Lazer therapy 5times a week which is the low level lazer plus Electro Acupuncture to stimulate the ulnar nerve. Is all this additional support good for the nerve?
doctor
Answered by Dr. Olsi Taka (11 hours later)
Brief Answer:
Read below

Detailed Answer:
It is obvious by the many things you have been trying that you are a little frustrated and find it difficult to remain optimistic. You shouldn't give up, as I said it takes time and at your young age there is every reason to be hopeful for a satisfactory regeneration process.

As for those measures you mention, there is some mild benefit from supplements, laser therapy and probably acupuncture (part of alternative medicine so not many studies). However it is only a minor effect, nothing game changing, it is your body, your nerves and muscles which are responsible for the process, those interventions have a minor supportive effect, ensuring to creates the best conditions for the nerves. As for stem cell therapy I am not that supportive of that. I believe it offers endless possibilities but for now there are still many issues and mainly a research object, there are many centers which offer it with little benefit for financial gain purposes.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (2 hours later)
Yes that's correct it's very frustrating that is why I have gone to all the measures to do everything so that I can speed up the process. The Stemcell Dr was very much at first that it helps peripheral nerves regenerate quicker but to define quicker is not known. I will also be getting PRP injections in that arm as a regenerative medicine Dr said it will assist so that and everything else I will be keeping up. I have a diffusion Tractography scan coming up will that indicate anything? Also Dr please leave your URL so I may request you again.
doctor
Answered by Dr. Olsi Taka (14 hours later)
Brief Answer:
Read below

Detailed Answer:
Hello,
I am afraid tractography scan doesn't indicate anything regarding this specific issue. As for PRP treatment it may help with muscle atrophy, shouldn't bring any benefit to the nerve itself though.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Is It Possible To Rebuild The Lumbericals And The Hypotheaner Muscles Of The Hand Again?

Brief Answer: It is possible. Detailed Answer: I read your question carefully and I understand your anxiety regarding regaining the lost function. If the nerve surgery was successful it is certainly possible to regain the lost muscle bulk. The muscle fibers are there they just haven't had any stimulation by the nerve for a long time hence undergoing atrophy. The longer the wait between nerve damage and surgery the more marked the atrophy is. Naturally it is not a process which will happen over night. While the surgery took place 13 weeks ago it will take some time for the joined nerve fibers to create new synapses between them. The surgery links them mechanically but the development of synapses with chemical interaction in them takes time. Also that process is not perfect the new synapses may not be able to completely replace the function of the old ones. However at your young age there is a strong ground to be optimistic that there will be a satisfactory result. Ones the new synapses are formed which will take signals to the atrophied muscle the muscle bulk will start to develop. So as you can see it is a process with several stages which will take some time, may take up to a year. For that reason I wouldn't consider muscle implants or other interventions yet, only physical therapy at least for a year. I remain at your disposal for other questions.