Reconstruction for Nerve Palsy -Tendon Transfers and Nerve transfers-Reconstruction for Nerve Palsy -Tendon Transfers and Nerve transfers Overview

Reconstruction for Nerve Palsy -Tendon Transfers and Nerve transfers Overview

Pdf Summary

Nerve transfers involve using a functional muscle tendon unit to replace lost function due to a nerve injury or other conditions. Several key principles need to be considered before performing a tendon transfer. These include correcting contracture, ensuring tissue equilibrium, maintaining a straight line of pull, using one tendon for one function, ensuring adequate strength of the transferred tendon, and considering the amplitude of motion. The relative strengths and excursions of different muscles in the forearm and hand should also be taken into account when choosing a muscle for transfer. <br /><br />Tendon transfers can be used to restore lost function in various nerve injuries, such as radial nerve palsy, median nerve palsy, ulnar nerve palsy, and combined median and ulnar nerve palsies. For example, in radial nerve palsy, tendon transfers can be used to restore thumb extension and finger extension. In median nerve palsy, transfers can be used to restore thumb flexion and finger flexion. In ulnar nerve palsy, transfers can be used to prevent clawing and restore power pinch. <br /><br />Nerve transfers can also be used for motor restoration and sensory restoration. Motor restoration transfers include transferring the intercostal nerve to the biceps branch of the musculocutaneous nerve for elbow flexion, transferring the spinal accessory nerve to the suprascapular nerve for shoulder abduction/flexion, and transferring the anterior interosseous nerve to the motor branch of the ulnar nerve or the recurrent branch of the median nerve for hand intrinsic function. Sensory restoration transfers involve transferring sensory nerves to critical areas of hand sensation.<br /><br />Overall, nerve transfers can provide functional restoration in patients with nerve injuries. However, careful evaluation and appropriate surgical decision-making are crucial to achieve successful outcomes.

Keywords

nerve transfers

tendon transfer

contracture correction

tissue equilibrium

straight line of pull

forearm muscles

thumb extension

finger flexion

clawing prevention

sensory restoration