The authors report the results of 15 tendon transfer cases for isolated radial (9 cases) and posterior interosseous nerve (6 cases) palsies. The patients were examined at a mean of 9.5 years after surgery. Thirteen patients were satisfied and demonstrated good wrist and finger metacarpophalangeal joint extension. One issue of concern involved radial wrist deviation: observed in cases with transfer of the flexor carpi ulnaris to the extensor digitorum communis.
Several combinations of tendon transfers are available to treat high and low radial nerve palsies. The authors of this report advocate a modified Tsuge procedure for high radial nerve palsies: 1) transfer of the pronator teres to restore extension of the wrist, 2) transfer of the flexor carpi radialis for extension of the fingers, 3) transfer of the palmaris longus for extension of the thumb, and 4) tenodesis of the abductor pollicus longus to the brachioradialis for abduction of the thumb. In low radial nerve palsies, transfer of the pronator teres for wrist extension is not necessary, but balanced wrist extension may necessitate transfer of the extensor carpi radialis longus to the extensor carpi radialis brevis.
Radial, Nerve, Palsy, Tendon, Transfer
J Hand Surg