Outcome of tendon transfer for radial nerve palsy using Flexor Carpi Radialis combination (Brands transfer)

The hand grip is severely impaired following high radial nerve palsy due to loss of extension of the wrist, metacarpo- phalangeal joint of fingers and thumb. If radial nerve does not show neural recovery following conservative or surgical repair during the optimum time, tendon transfer is considered the standard treatment. To evaluate and compare the clinical outcome between flexor carpi radialis and flexor carpiulnaris tendon transfer for fingers’ extension in high radial nerve palsy. This randomized controlled trial study was carried out in the Department of Orthopedic Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka over a period of two years from January 2013 to December 2014. A total of 30 patients with high radial nerve palsy were recruited, 15 patients were gone through Flexor Carpi Radialis tendon transfer procedure (FCR group) and the rest 15 patients were gone through Flexor Carpi Ulnaris tendon transfer procedure(FCU group). The patients were followed up for 12 weeks after surgical intervention. Out of all patients, 86.7% male were encountered in each group. The mean age was found 31.07±9.14 years in FCR group and 33.60±10.79 years in FCU group. Humerus fracture was remained a major cause of radial nerve palsy in both FCR and FCU groups (26.7% vs. 33.3%). In final follow-up at 12th week, no extension deficit was observed at MCP joint (93.3% vs. 80.0%, p>0.05).The end result of surgical intervention was found satisfactory equally in both the groups (86.7%). In case of high radial nerve palsy, both FCR and FCU tendon transfer procedures are effective forfingers’ extension at MCP joint. Bangladesh Med J. 2019 Sep; 48 (3): 9-15

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Radial Nerve Palsy: Nerve Transfer Versus Tendon Transfer to Restore Function

Hand ◽

10.1177/1558944720988126 ◽

2021 ◽

pp. 155894472098812

Author(s):

J. Megan M. Patterson ◽

Stephanie A. Russo ◽

Madi El-Haj ◽

Christine B. Novak ◽

Susan E. Mackinnon

Keyword(s):

Radial Nerve ◽

Tendon Transfer ◽

Nerve Palsy ◽

Nerve Transfer ◽

Pinch Strength ◽

Radial Nerve Palsy ◽

Nerve Injuries ◽

Tendon Transfers ◽

Nerve Transfers ◽

Transfer Group

Background: Radial nerve injuries cause profound disability, and a variety of reconstruction options exist. This study aimed to compare outcomes of tendon transfers versus nerve transfers for the management of isolated radial nerve injuries. Methods: A retrospective chart review of 30 patients with isolated radial nerve injuries treated with tendon transfers and 16 patients managed with nerve transfers was performed. Fifteen of the 16 patients treated with nerve transfer had concomitant pronator teres to extensor carpi radialis brevis tendon transfer for wrist extension. Preoperative and postoperative strength data, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and quality-of-life (QOL) scores were compared before and after surgery and compared between groups. Results: For the nerve transfer group, patients were significantly younger, time from injury to surgery was significantly shorter, and follow-up time was significantly longer. Both groups demonstrated significant improvements in grip and pinch strength after surgery. Postoperative grip strength was significantly higher in the nerve transfer group. Postoperative pinch strength did not differ between groups. Similarly, both groups showed an improvement in DASH and QOL scores after surgery with no significant differences between the 2 groups. Conclusions: The nerve transfer group demonstrated greater grip strength, but both groups had improved pain, function, and satisfaction postoperatively. Patients who present early and can tolerate longer time to functional recovery would be optimal candidates for nerve transfers. Both tendon transfers and nerve transfers are good options for patients with radial nerve palsy.

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The “Double Wrist Flexor” Tendon Transfer for Radial Nerve Palsy

Annals of Plastic Surgery ◽

10.1097/sap.0b013e31823dcdc5 ◽

2013 ◽

Vol 71 (1) ◽

pp. 34-36 ◽

Cited By ~ 3

Author(s):

Mohammad Al-Qattan

Keyword(s):

Radial Nerve ◽

Tendon Transfer ◽

Nerve Palsy ◽

Flexor Tendon ◽

Radial Nerve Palsy ◽

Wrist Flexor

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Modification of Tendon Transfer Surgery for Radial Nerve Palsy due to Pre-operatively Observed, Unexpected Partial Return of Wrist Extension

American Medical Student Research Journal ◽

10.15422/amsrj.2015.03.007 ◽

2015 ◽

Vol 1 (2) ◽

Author(s):

Nicholas Calotta ◽

Gene Deune

Keyword(s):

Radial Nerve ◽

Tendon Transfer ◽

Nerve Palsy ◽

Radial Nerve Palsy ◽

Wrist Extension

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Tomasz Drobnik and Felix Franke: Who Was the First in History to Treat Radial Nerve Palsy by Tendon Transfer?

Plastic & Reconstructive Surgery ◽

10.1097/prs.0b013e3181ea9060 ◽

2010 ◽

Vol 126 (4) ◽

pp. 1409-1410 ◽

Cited By ~ 2

Author(s):

Andreas Gohritz ◽

Karsten Knobloch ◽

Peter M. Vogt ◽

Jan Fridén

Keyword(s):

Radial Nerve ◽

Tendon Transfer ◽

Nerve Palsy ◽

Radial Nerve Palsy

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Who Was the First in History to Treat Radial Nerve Palsy by Tendon Transfer?

Plastic & Reconstructive Surgery ◽

10.1097/prs.0b013e3181c87b58 ◽

2010 ◽

Vol 125 (2) ◽

pp. 756-757 ◽

Cited By ~ 4

Author(s):

Steven F. S. Korteweg ◽

Robert C. van de Graaf ◽

Paul M. N. Werker

Keyword(s):

Radial Nerve ◽

Tendon Transfer ◽

Nerve Palsy ◽

Radial Nerve Palsy

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Irreparable Radial Nerve Palsy Due to Delayed Diagnostic Management of a Giant Lipoma at the Proximal Forearm Resulting in a Triple Tendon Transfer Procedure: Case report and Brief Review of Literature

The Open Orthopaedics Journal ◽

10.2174/1874325001711010794 ◽

2017 ◽

Vol 11 (1) ◽

pp. 794-803 ◽

Cited By ~ 2

Author(s):

Ingo Schmidt

Keyword(s):

Functional Recovery ◽

Radial Nerve ◽

Tendon Transfer ◽

Nerve Palsy ◽

Radial Nerve Palsy ◽

Patient Reported ◽

Diagnostic Management ◽

Giant Lipoma ◽

Proximal Forearm

Background: Non-traumatic radial nerve palsy (RNP) caused by local tumors is a rare and uncommon entity. Methods: A 62-year-old female presented with a left non-traumatic RNP, initially starting with weakness only. It was caused by a benign giant lipoma at the proximal forearm that was misdiagnosed over a period of 2 years. The slowly growth of the tumor led to an irreparable overstretching-related partial nerve disruption. For functional recovery of the patient, a triple tendon transfer procedure had to be performed. Results: Four months after surgery, the patient was completely able to perform her activities of daily living again. At the 10-months follow-up, strength of wrist extension, thumb's extension and abduction, and long fingers II-V extension had all improved to grade 4 in Medical Research Council scale (0-5). In order to restore motion, the patient reported that she would undergo the same triple tendon transfer procedure a second time where necessary. Due to the initially misdiagnosed tumor, there was an overall delayed duration of time for functional recovery of the patient. Conclusion: The triple tendon transfer procedure offers a useful and reliable method to restore functionality for patients sustaining irreparable RNP. However, it must be noted critically with our patient that this procedure probably would have been avoided. Initially, there was weakness only by entrapment of the radial nerve. RNP caused by local tumors are uncommon but known from the literature, and so it should be considered generally in differential diagnosis of non-traumatic RNP.

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