[The results of tendon transfer in irreparable radial nerve palsy]

Ufuk Nalbantoğlu, Türker Ozkan, I Metin Türkmen
Acta Orthopaedica et Traumatologica Turcica 2008, 42 (5): 350-7

OBJECTIVES: The purpose of this study was to evaluate the results of tendon transfers in patients with irreparable radial nerve palsy.

METHODS: The study included 29 patients (5 females, 24 males; mean age 29 years; range 9 to 51 years) who underwent tendon transfers for radial nerve palsy. Four patients had low- and 25 patients had high-level radial nerve palsy. The mean duration of tendon transfer after injury (paralysis time) was 19.7 months (range 1 day to 180 months). Clinical evaluations included joint range of motion and muscle strengths. Functional evaluation was made using the Tajima criteria. The mean follow-up was 56.9 months (range 5 to 90 months).

RESULTS: Muscle strengths were measured as follows: 3 (n=3), 4 (n=10), and 5 (n=12) for the wrist extensor muscle; 3 (n=7), 4 (n=10), and 5 (n=12) for the finger extensor muscle; and 3 (n=6), 4 (n=13), and 5 (n=10) for the thumb extensor muscle. The mean wrist range of motion was 67.4 degrees , extension was 48.3 degrees (10 degrees to 70 degrees ), and flexion was 21.5 degrees (10 degrees to 55 degrees ). The mean metacarpophalangeal joint extension was 1.7 degrees (0 degrees to 12 degrees ), thumb abduction was 45.6 degrees (34 degrees to 56 degrees ), and thumb interphalangeal joint extension was 18 degrees (0 degrees to 30 degrees ). According to the Tajima criteria, the results were excellent in 15 patients (51.7%), good in nine patients (31%), and moderate in five patients (17.2%). Eight patients (27.6%) had radial deviation deformity and four patients (13.8%) had 1-level weaker finger extensor muscle strength compared to the other fingers. The flexor carpi ulnaris (FCU) was used in the transfer of patients who developed radial deviation deformity.

CONCLUSION: Treatment of irreparable radial nerve palsy with tendon transfers yields successful results. Radial deviation deformity mostly occurs in patients receiving FCU transfer for finger extension.

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