scholarly journals Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion

2018 ◽  
Vol 51 (02) ◽  
pp. 123-130 ◽  
Author(s):  
R. Srikanth ◽  
Koteswara Rao Rayidi ◽  
Subha Kakumanu
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Tendon Transfer ◽  
Hand Function ◽  
Flexor Digitorum Profundus ◽  
Tendon Transfers ◽  
Wrist Extensor ◽  
Nerve Transfers ◽  
Finger Flexion ◽  
Flexor Digitorum

ABSTRACT Introduction: The main deformity following an adult lower brachial plexus injury is the loss of finger flexion. Distal nerve transfers have been used to restore finger and thumb flexion followed by tendon transfers for intrinsic replacement for opening of the fingers. When patients present beyond 6 months, only tendon transfers are applicable. Since the brachioradialis (BR) is always spared in such injuries, it is the ideal muscle to provide finger flexion. Wrist extensor power may not be normal for the use of the radial wrist extensor to serve as donor. BR to FDP transfer provides reasonable flexion range and an acceptable hand function to permit activities of daily living, when associated with ancillary procedures like opponensplasty, PIPJ arthrodesis. Materials and Methods: Eleven patients underwent a BR to FDP tendon transfer between January 2013 and January 2017 of which eight patients came for follow-up. Results: Four of the eight patients got a functionally useful hand to carry out activities of daily living with hook grip, span grasp, key pinch, chuck grip and pulp pinch. These patients also underwent simultaneous or secondary ancillary procedures. Four of the patients need secondary procedures to further improve functionality of the hand inspite of having a flexion range. Conclusion: The BR is an effective donor in providing adequate range and power of finger flexion in lower plexus injuries.

Brachioradialis Transfer for Digital Palsy

1990 ◽  
Vol 15 (3) ◽  
pp. 312-316
Author(s):  
J. M. FAILLA ◽  
C. A. PEIMER ◽  
F. S. SHERWIN
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Tendon Transfer ◽  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Pinch Grip ◽  
The Common ◽  
Finger Motion ◽  
Flexor Digitorum ◽  
Tendon Excursion

Although brachioradialis tendon transfer is thought to offer limited tendon excursion and finger motion, we have used it to restore active thumb and digital function in eight patients. Three had Volkmann’s contracture, one avulsion of forearm muscles and four had tetraplegia resulting in inability to perform activities of daily living and loss of pinch or grasp and extrinsic extension. The brachioradialis was transferred to the flexor pollicis longus, to the flexor digitorum profundus or to the common digital extensors. Except for one patient who had unremitting pain, all were pleased with their improved motion, pinch, grip, and independence. Function, however, remained abnormal in all but one.

Improvement in Activities of Daily Living Using the Freehand: A System Designed for People with Tetraplegia

2003 ◽  
Vol 66 (3) ◽  
pp. 113-117 ◽  
Author(s):  
Julie Esnouf ◽  
Paul Taylor ◽  
John Hobby
Keyword(s):  
Activities Of Daily Living ◽  
Functional Ability ◽  
Daily Living ◽  
Tendon Transfer ◽  
Hand Function ◽  
International Classification ◽  
Home Work ◽  
Set Up ◽  
Implanted Device ◽  
At Home

The Freehand system is an implanted device for people with C5/6 tetraplegia, international classification 0, 1 and 2. The implant is designed to improve hand function, particularly in those who lack voluntary muscles suitable for tendon transfer. This study investigated how the Freehand system was being used at home, work and leisure. Twelve participants, who were assessed, implanted and trained with the Freehand system, were reviewed against their preoperative goals. Prior to surgery, eight activities of daily living goals that the participant would like to perform with the Freehand system were selected by him or her. Each task was assessed in three sections: the set-up of the task, the performance and the take-down. The amount of assistance for each section was recorded. This was repeated after training had been completed and daily use established. Each participant was also asked to state a preference on how the tasks would be completed, whether with the system or by the method prior to surgery. The results of this study show an improvement in the participants' functional ability in their selected goals when using the Freehand system. The preference for using the Freehand system to complete tasks applied to 84% of the total 96 tasks chosen by the 12 participants in this study.

Transfer of the Distal Terminal Motor Branch of the Extensor Carpi Radialis Brevis to the Nerve of the Flexor Pollicis Longus

Neurosurgery ◽  
2011 ◽  
Vol 70 (4) ◽  
pp. 1011-1016 ◽  
Author(s):  
Jayme Augusto Bertelli ◽  
Vera Lúcia Mendes Lehm ◽  
Cristiano Paulo Tacca ◽  
Elisa Cristiana Winkelmann Duarte ◽  
Marcos Flávio Ghizoni ◽  
...  
Keyword(s):  
Tendon Graft ◽  
Flexor Digitorum Profundus ◽  
Orthopedic Procedures ◽  
Flexor Pollicis Longus ◽  
Motor Branch ◽  
Nerve Transfers ◽  
Finger Flexion ◽  
Distal Branch ◽  
Flexor Digitorum ◽  
Extensor Carpi Radialis

Abstract BACKGROUND: In tetraplegics, thumb and finger motion traditionally has been reconstructed via orthopedic procedures. Although rarely used, nerve transfers are a viable method for reconstruction in tetraplegia. OBJECTIVE: To investigate the anatomic feasibility of transferring the distal branch of the extensor carpi radialis brevis (ECRB) to the flexor pollicis longus (FPL) nerve and to report our first clinical case. METHODS: We studied the motor branch of the ECRB and FPL in 14 cadaveric upper limbs. Subsequently, a 24-year-old tetraplegic man with preserved motion in his shoulder, elbow, wrist, and finger extension, but paralysis of thumb and finger flexion underwent surgery. Seven months after trauma, we transferred the brachialis muscle with a tendon graft to the flexor digitorum profundus. The distal nerve of the ECRB was transferred to the FPL nerve. RESULTS: The branch to the ECRB entered the muscle in its anterior and proximal third. After sending out a first collateral, the nerve runs for 2.4 cm alongside the muscle and bifurcates intramuscularly. A main branch from the anterior interosseous nerve, which entered the muscle 3 cm from its origin on the radius, innervated the FPL. The ECRB and FPL nerves had similar diameters (∼1 mm) and numbers of myelinated fibers (∼180). In our patient, 14 months after surgery, pinching and grasping were restored and measured 2 and 8 kg strength, respectively. CONCLUSION: Transfer of the ECRB distal branch to the FPL is a viable option to reconstruct thumb flexion.

The Outcome of Tendon Transfers for C6-Spared Quadriplegics

1998 ◽  
Vol 23 (2) ◽  
pp. 156-161 ◽  
Author(s):  
I. K. Y. LO ◽  
R. TURNER ◽  
S. CONNOLLY ◽  
G. DELANEY ◽  
J. H. ROTH
Keyword(s):  
Grip Strength ◽  
Daily Living ◽  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Tendon Transfers ◽  
Flexor Digitorum ◽  
Extensor Carpi Radialis ◽  
Uniform Group

The purpose of this study was to review retrospectively and evaluate a uniform group of C6-spared quadriplegics who had similar surgical procedures. Eight patients undergoing 12 procedures were reviewed at an average of 3.8 years follow-up. There were three bilateral procedures. All patients had extensor carpi radialis longus to flexor digitorum profundus and brachioradialis to flexor pollicis longus transfers to improve grip strength and key pinch. All patients reported subjective improvements in quality of life, activities of daily living and patient-centred goals. There were six excellent and two good results. Objective improvements included mild improvements in key pinch and grip strength.

Multiple nerve and tendon transfers: a new strategy for restoring hand function in a patient with C7–T1 brachial plexus avulsions

2017 ◽  
Vol 127 (4) ◽  
pp. 837-842 ◽  
Author(s):  
Bin Xu ◽  
Zhen Dong ◽  
Cheng-Gang Zhang ◽  
Yu-Dong Gu
Keyword(s):  
Brachial Plexus ◽  
Grip Strength ◽  
Hand Function ◽  
Motor Branch ◽  
Pronator Teres ◽  
Nerve Transfers ◽  
Finger Flexion ◽  
New Strategy ◽  
Flexor Digitorum ◽  
Flexion Strength

C7–T1 brachial plexus palsies result in a loss of finger motion and hand function. The authors have observed that finger flexion motion can be recovered after a brachialis motor branch transfer. However, finger flexion strength after this procedure merely corresponds to Medical Research Council Grades M2–M3, lowering the grip strength and practical value of the reconstructed hand. Therefore, they used 2 donor nerves and accomplished double nerve transfers for stronger finger flexion. In a patient with a C7–T1 brachial plexus injury, they transferred the pronator teres branch to the anterior interosseous nerve and the brachialis motor branch to the flexor digitorum superficialis branch for reinnervation of full finger flexors. Additionally, the supinator motor branch was transferred for finger extension, and the brachioradialis muscle was used for thumb opposition recovery. Through this new strategy, the patient could successfully accomplish grasping and pinching motions. Moreover, compared with previous cases, the patient in the present case achieved stronger finger flexion and grip strength, suggesting practical improvements to the reconstructed hand.

Using the Internet to assess activities of daily living and hand function in people with Parkinson's disease

2008 ◽  
Vol 23 (3) ◽  
pp. 253-261 ◽  
Author(s):  
Tammy Hoffmann ◽  
Trevor Russell ◽  
Leah Thompson ◽  
Amy Vincent ◽  
Mark Nelson
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Hand Function ◽  
The Internet

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.

Assessment of Hand Function: A Review of Some Tests in Common Use

1985 ◽  
Vol 48 (12) ◽  
pp. 360-362 ◽  
Author(s):  
J A Dent ◽  
Margaret Smith ◽  
Jeannette Caspers
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Elective Surgery ◽  
Hand Function ◽  
Trauma Patients ◽  
Realistic Description

In studies of hand function recently carried out in Edinburgh, one of the problems was to find valid comprehensive measures of outcome following trauma or elective surgery. A small supplementary study was therefore undertaken to examine some commonly used tests of strength and dexterity, and to compare the results with the use of the hand in activities of daily living (ADL). The results indicated that ADL function was more closely correlated with strength than with dexterity. However, no test used in isolation gave a realistic description of hand function for either rheumatoid or trauma patients. It is therefore suggested that a battery of tests, including ADL assessment related to individual need, is necessary.

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