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Median to radial nerve transfer for treatment of radial nerve palsy. Case report.

AbstractThe purpose of this study is to report a surgical technique of nerve transfer to restore radial nerve function after a complete palsy due to a proximal injury to the radial nerve. The authors report the case of a patient who underwent direct nerve transfer of redundant or expendable motor branches of the median nerve in the proximal forearm to the extensor carpi radialis brevis and the posterior interosseous branches of the radial nerve. Assessment included degree of recovery of wrist and finger extension, and median nerve function including pinch and grip strength. Clinical evidence of reinnervation was noted at 6 months postoperatively. The follow-up period was 18 months. Recovery of finger and wrist extension was almost complete with Grade 4/5 strength. Pinch and grip strength were improved postoperatively. No motor or sensory deficits related to the median nerve were noted, and the patient is very satisfied with her degree of functional restoration. Transfer of redundant synergistic motor branches of the median nerve can successfully reinnervate the finger and wrist extensor muscles to restore radial nerve function. This median to radial nerve transfer offers an alternative to nerve repair, graft, or tendon transfer for the treatment of radial nerve palsy.
AuthorsSusan E Mackinnon, Brandon Roque, Thomas H Tung (Affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. mackinnons at wustl.edu)
JournalJournal of neurosurgery (J Neurosurg) Vol. 107 Issue 3 Pg. 666-71 (Sep 2007) ISSN: 0022-3085 United States
PMID17886570 (Publication Type: Case Reports, Journal Article)
Topics
  • Adult
  • Female
  • Humans
  • Median Nerve (surgery)
  • Nerve Transfer (methods)
  • Paralysis (etiology, surgery)
  • Radial Nerve (injuries)