♦ Late reconstructive procedures may improve function if there is persisting paralysis after nerve injury♦ Transfer of a functioning musculotendinous unit to the tendon of the paralysed muscle is the most common type of procedure♦ Passive mobility must be maintained in affected joints before tendon transfer can be performed♦ The transferred muscle should be expendable, have normal power, and have properties appropriate to the function it is required to restore♦ Tendon transfers can provide reliable improvement in function after isolated radial nerve palsy♦ A number of procedures have been described for reconstruction of thumb opposition but impaired sensation after median nerve injury may limit gain in function♦ Tendon transfers are possible to improve clawing of fingers and lateral pinch of the thumb after ulnar nerve palsy or other cases of intrinsic paralysis.
Primary defects of the hand with intrinsic paralysis
