Tendon Transfers in Upper Extremity Reconstruction

2019 ◽  
pp. 1015-1018
Author(s):  
Vincent G. Laurence ◽  
Gregory Rafijah
Keyword(s):  
Peripheral Nerve ◽  
Upper Extremity ◽  
Nerve Injury ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Radial Nerve Palsy ◽  
Tendon Transfers ◽  
History Of ◽  
Extremity Reconstruction ◽  
Radial Nerve Injury

Tendon transfers, first performed more than 100 years ago, remain one of the most powerful tools in the hand surgeon’s repertoire for addressing chronic peripheral nerve palsies. Dozens of transfers have been described in the intervening years, but three sets of transfers to provide wrist, finger, and thumb extension after a high radial nerve injury remain among the most commonly performed. This chapter briefly discusses the history of tendon transfers; outlines the general principles, indications, and timing of transfers; and provides a detailed, step-by-step description of the authors’ preferred set of transfers (the FCR set) for a high radial nerve palsy.

scholarly journals Iatrogenic Radial Nerve Palsy following Closed Reduction of a Simple Diaphyseal Humeral Fracture: Beware the Perfect X-Ray

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Morgan Jones ◽  
Hean Wu Kang ◽  
Christopher O’Neill ◽  
Paul Maginn
Keyword(s):  
Nerve Injury ◽  
Clinical Assessment ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Humeral Fracture ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Radial Nerve Palsy ◽  
X Ray ◽  
Radial Nerve Injury

Radial nerve injury is a recognised complication associated with humeral shaft fracture. A case of iatrogenic radial nerve injury is presented following fracture reduction. The relevant anatomy, challenges in management of humeral fractures with associated radial nerve injury, and the importance of detailed clinical assessment and documentation are discussed.

scholarly journals Managing Radial Nerve Injuries Associated with Humeral Fracture

2020 ◽  
Vol 71 (1) ◽  
pp. 400-404
Author(s):  
Vlad Carbunaru ◽  
Ana Maria Oproiu ◽  
Adrian Barbilian ◽  
Chen Feng-Ifrim ◽  
Alexandra Ciotei
Keyword(s):  
Nerve Injury ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Bone Fractures ◽  
Humeral Fracture ◽  
High Energy ◽  
Humeral Shaft ◽  
Long Bone ◽  
Radial Nerve Palsy ◽  
Radial Nerve Injury

The overall prevalence of radial nerve injury after humeral shaft fractures is up to 18% representing the most common peripheral nerve injury associated with long bone fractures. Spiral or oblique fractures of the junction between the middle and distal third of the humeral shaft are at greater risk for radial nerve injury. Iatrogenic damage to the radial nerve may also occur during manipulations of closed reduction. A prospective study between 2017-2019 following 5 patients (all male, with ages between 30 and 56 years old), who were treated at our clinic for complete radial nerve palsy after a high-energy fracture of the humerus. All the patients were followed-up for a mean of 6 months (range 4 - 15 months) post op. The first 3 cases showed the initial signs of recovery 4 weeks after the operation. In the last 2 cases a palliative radial intervention was required. The consequences of the radial nerve palsy associated with humeral fractures is strongly related to trauma mechanism. In high energy fractures, severe contusion or transection of the nerve must be expected. In this case, nerve recovery is unlikely and the patients should be informed of the poor prognosis and the need of tendon transfers.

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

Hand ◽  
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.

scholarly journals Radial Nerve Palsy following Endovascular Embolization of an Arteriovenous Malformation

2017 ◽  
Vol 07 (03) ◽  
pp. 258-261
Author(s):  
Ram Alluri ◽  
Anuj Mahajan ◽  
Alidad Ghiassi ◽  
Venus Vakhshori
Keyword(s):  
Peripheral Nerve ◽  
Radial Nerve ◽  
Nerve Palsy ◽  
Case Reports ◽  
Endovascular Embolization ◽  
Careful Consideration ◽  
Radial Nerve Palsy ◽  
Direct Compression ◽  
Endovascular Techniques

Background Arteriovenous malformations (AVMs) are commonly treated using endovascular techniques. Previous nerve palsies after embolization have been reported as isolated case reports, none of which affected the forearm. Case Description A case of acute, transient neuropathy of the radial nerve following embolization of a forearm AVM is described. The patient, an otherwise healthy 27-year-old man, began having symptoms of superficial radial nerve (SRN) and posterior interosseous nerve (PIN) palsies immediately following endovascular embolization. He underwent decompression of the radial nerve within 5 days and was found to have direct compression of the PIN and SRN. The patient recovered completely at the time of his 7-month follow-up. Literature Review Few cases of nerve palsy after endovascular embolization have been reported in the literature. Many are intracranial, but rare instances of peripheral nerve palsy have been reported, including two sciatic nerve and four digital nerve palsies after endovascular embolization. No cases of peripheral nerve palsy in the forearm have been reported. Clinical Relevance We recommend careful consideration of surrounding neural elements at risk for palsy prior to endovascular embolization and detailed discussion with the patient during the informed consent process.

scholarly journals Humeral shaft fracture associated with radial nerve palsy -a case report

2021 ◽  
pp. 54-55
Author(s):  
Rishitha M ◽  
Akasha Sindhu M
Keyword(s):  
Radial Nerve ◽  
Nerve Palsy ◽  
Wrist Joint ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Loss Of Function ◽  
History Of ◽  
The Right

Radial nerve palsy was induced by radial nerve compression, which was often caused by humerus bone fracture. This leads to pain, weakness, or loss of function mostly in the wrist, hand, and fingers. We reported a case of a 24-year-old male patient with complaints of swelling of the right-hand wrist joint and pain during extension and flexion while moving. He had a three-month history of mild displaced humeral shaft fracture from a traffic accident and an intramedullary Ender nailing was performed. He now has been admitted with swelling in his right wrist joint and pain while moving his hand. The case was diagnosed as Radial nerve palsy. Surgery was performed, the proximal and distal ends of the radial nerve were separated at the humeral bone's surface. The radial nerve stumps were enough long to be sutured. Our one-month follow-up shows no complications. The majority cases of radial nerve palsy will resolve within a few weeks after surgery, as our patient did, and the most prominent is patient education.

Tendon transfers in radial nerve palsy

1997 ◽  
Vol 26 (8) ◽  
pp. 666-672
Author(s):  
P. Hahn ◽  
U. Lanz
Keyword(s):  
Radial Nerve ◽  
Nerve Palsy ◽  
Radial Nerve Palsy ◽  
Tendon Transfers
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