Treatment of Irreversible Lesion of the Radial Nerve by Tendon Transfer: Indication and Long-Term Results of the Merle d'Aubign?? Procedure

Aims Since long-term outcome of teres major tendon transfer surgery for irreparable posterosuperior rotator cuff (RC) tears is largely unknown, the primary aim of this study was to evaluate the long-term outcome of the teres major transfer. We also aimed to report on the results of a cohort of patients with a similar indication for surgery that underwent a latissimus dorsi tendon transfer. Patients and Methods In this prospective cohort study, we reported on the long-term results of 20 consecutive patients with a teres major tendon transfer for irreparable massive posterosuperior RC tears. Additionally, we reported on the results of the latissimus dorsi tendon transfer (n = 19). The mean age was 60 years (47 to 77). Outcomes included the Constant score (CS), and pain at rest and during movement using the Visual Analogue Scale (VAS). Results At a mean of ten years (8 to 12) following teres major transfer, the CS was still 23 points (95% confidence interval (CI) 14.6 to 30.9, p < 0.001) higher than preoperatively. VAS for pain at rest (21 mm, 95% CI 4.0 to 38.9, p = 0.016) and movement (31 mm, 95% CI 16.0 to 45.1, p < 0.001) were lower than preoperatively. We also found an increase in CS (32 points, 95% CI 23.4 to 40.2, p < 0.001) and reduction of pain (26 mm, 95% CI 9.9 to 41.8, p = 0.001) six years after latissimus dorsi transfer. Conclusion Teres major tendon transfer is a treatment option to gain shoulder function and reduce pain in patients with an irreparable posterosuperior RC tear at a mean follow-up of ten years. The teres major tendon might be a valuable alternative to the commonly performed latissimus dorsi tendon transfer in the treatment of irreparable posterosuperior RC tears. Cite this article: Bone Joint J 2018;100-B:309–17.

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Long-Term Results of Tendon Transfers for Radial Nerve Paisy in Patients With Limited Rehabilitation

Annals of Plastic Surgery ◽

10.1097/00000637-200045020-00004 ◽

2000 ◽

Vol 45 (2) ◽

pp. 122-126 ◽

Cited By ~ 18

Author(s):

Paul J. Skoll ◽

Donald A. Hudson ◽

Wikus de Jager ◽

Martin Singer

Keyword(s):

Radial Nerve ◽

Long Term Results ◽

Tendon Transfers

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Delayed Treatment of Persistent Radial Nerve Paralysis Associated with Fractures of the Middle Third of Humerus: Review and Evaluation of the Long-Term Results of 52 Cases

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhse.2007.02.206 ◽

2007 ◽

Vol 32 (5) ◽

pp. 529-533 ◽

Cited By ~ 9

Author(s):

M. VERGA ◽

A. PERI DI CAPRIO ◽

M. A. BOCCHIOTTI ◽

F. BATTISTELLA ◽

S. BRUSCHI ◽

...

Keyword(s):

Functional Recovery ◽

Radial Nerve ◽

Humeral Fracture ◽

Long Term Results ◽

Nerve Paralysis ◽

Surgical Exploration ◽

Delayed Treatment ◽

Nerve Grafts ◽

Nerve Surgery

This study was undertaken to determine the efficacy of delayed surgical treatment in cases of persistent radial nerve paralysis after fractures of the middle third of the humerus. We have limited this study to patients who had absolutely no functional recovery of the radial nerve 3 to 4 months after middle third humeral fractures. The fractures were treated by a variety of orthopaedic methods, conservative and surgical, in other departments and hospitals. Surgical exploration of the radial nerve was carried out 3 to 4 months after primary orthopaedic treatment. The outcome of this study concurs with data in the literature in showing that delayed nerve surgery (neurolysis or nerve grafts) in the absence of functional recovery of the radial nerve after humeral fracture can be useful in achieving good functional recovery and subjectively satisfying results.

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