The restoration of hand functions after irreparable injury of the radial nerve

Zbigniew Deskur, Anna Deskur

Abstract


Introduction: The aim of our study was to evaluate the methods used and results achieved for the restoration of function of the hands in patients with irreparable injury to the radial nerve.

Materials and methods: We studied the type and number of methods used for the restoration of mobility function of the hands by tendon transfer of active muscle to affected muscle. Moreover, we implemented rehabilitation treatment in patients with irreparable injury to the radial nerve. Descriptions of the treatment were presented in 100 scientific reports published between 1996 and 2015 The available literature presents the results of the treatment of 129 patients with irreparable injury to the radial nerve.

Results: The restoration activities of patients’ hand function was most frequently done by tendon transfer, i.e. the pronator teres muscle on the extensor carpi radialis brevis in 100 (72.5%) patients, the palmaris longus muscle on the extensor pollicis longus in 88 (68.2%) patients, and the flexor carpii ulnaris muscle on the extensor digitorum communis in 99 (77.7%) patients. During the pre- and postoperative period rehabilitation treatment played a crucial role in the restoration of patients’ hand functions.

Conclusions: All patients regained a complete or almost complete extension of the wrist and fingers. The strength of the hands was generally satisfactory. The dexterity of the hands in the majority of the studied patients was very good or good.


Keywords


irreparable injury to the radial nerve; restoration of hand functions; tendon transfer

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References


Deskur Z. Wartość wybranych metod operacyjnego odtwarzania czynności ręki po nieodwracalnych uszkodzeniach nerwu promieniowego i łokciowego. Szczecin: PAM; 1996.

Seiler JG, Desai MJ, Payne SH. Tendon transfers for radial, median, and ulnar nerve palsy. J Am Acad Orthop Surg 2013;21:675-84.

Walczak S, Pieniążek M, Pelczar-Pieniążek M, Tabasz M. Zasadność i skuteczność postępowania fizjoterapeutycznego po transferach ścięgien u pacjentów z nieodwracalnym uszkodzeniem nerwu promieniowego. Ortop Traumatol Rehabil 2005;7(2):187-97.

Sankaran A, Thora A, Arora S, Dhal A. Single tendon transfer of the flexor carpi ulnaris for high radial nerve injury. J Orthop Surg (Hong Kong) 2015;23(3):345-8.

Monacelli G, Spagnoli AM, Rizzo MI, Sorvillo V, Scuderi N. Treatment of persistent radial nerve palsy through “tendon minimal transfer” technique. G Chir 2011;32(1/2):69-72.

Moussavi AA, Saied A, Karbalaeikhani A. Outcome of tendon transfer for radial nerve paralysis: comparison of three methods. Indian J Orthop 2011;45:558-62.

Bincaz LE, Cherifi H, Alnot JY. Les transferts palliatifs de reanimation de l’extension du poignet et des doigts. A propos de 14 transferts for radial nerve palsies and ten transferts for brachial plexus lesions. Chir Main 2002;21(1):13-22.

Kozin SH. Tendon transfers for radial and median nerve palsies. J Hand Ther 2005;18(2):208-15.

Moore AM. Tendon transfers for nerve palsies. Washington University School of Medicine. 2015.

Martinez-Villen G, Munoz-Marin J, Perez-Barrero P. Are tendon transfers justifried in very old hand radial palsies? J Plast Reconstr Aesthet Surg 2012;65(10):293-6.

Koulaxouzidis G, Stark GB, Lampert FM. Motorische Ersatzplastik durch Sehnentransposition bei Lahmung des Nerves radialis. Oper Orthop Traumatol 2015;27(1):47-62.




DOI: https://doi.org/10.21164/pomjlifesci.191

Copyright (c) 2016 Zbigniew Deskur, Anna Deskur

License URL: https://creativecommons.org/licenses/by-nc-nd/3.0/pl/