Acta Orthop Traumatol Turc
The results of tendon transfer in irreparable radial nerve palsy
Abstract
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°, extension was 48.3° (10°-70°), and flexion was 21.5° (10°-55°). The mean metacarpophalangeal joint extension was 1.7° (0°-12°), thumb abduction was 45.6° (34°-56°), and thumb interphalangeal joint extension was 18° (0°-30°). 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.
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°, extension was 48.3° (10°-70°), and flexion was 21.5° (10°-55°). The mean metacarpophalangeal joint extension was 1.7° (0°-12°), thumb abduction was 45.6° (34°-56°), and thumb interphalangeal joint extension was 18° (0°-30°). 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.