Reconstruction for Nerve Palsy -Tendon Transfers and Nerve transfers-Tendon Transfers for Radial,Median, and Ulnar Nerve Palsy

Tendon Transfers for Radial,Median, and Ulnar Nerve Palsy

Pdf Summary

Tendon transfers are used to restore function to a paralyzed, injured, or absent neuromuscular-motor unit, and are commonly used to restore function after injury to the radial, median, and ulnar nerves. The goal of tendon transfers is to improve the balance of a neurologically impaired hand. General principles of tendon transfer include minimizing the functional loss associated with the use of donor tendon, ensuring the strength of the proposed muscle for transfer is normal or near normal, and ensuring the tendon excursion of the donor unit is sufficient to restore the lost function of the recipient unit. Examples of tendon transfers for radial, median, and ulnar nerve palsy include the pronator teres (PT) to extensor carpi radialis brevis (ECRB) transfer, the flexor carpi radialis (FCR) to extensor digitorum communis (EDC) transfer, and the palmaris longus (PL) to extensor pollicis longus (EPL) transfer. Additionally, tendon transfers can be used to restore thumb opposition, thumb interphalangeal (IP) flexion, and finger flexion in cases of median nerve palsy, and to restore power pinch in cases of ulnar nerve palsy. Tendon transfers should be performed according to the general principles and the specific needs of the patient to maximize outcomes.

Keywords

Tendon transfers

Function restoration

Neuromuscular-motor unit

Radial nerve injury

Median nerve injury

Ulnar nerve injury

Donor tendon

Tendon excursion

Thumb opposition

Maximizing outcomes