Tendon transfers for radial nerve palsy with extensor carpi ulnaris revival: Technique and results.
Finger extension
Hand palsy
Radial nerve palsy
Tendon transfers
Thumb abduction
Wrist extension
Journal
Orthopaedics & traumatology, surgery & research : OTSR
ISSN: 1877-0568
Titre abrégé: Orthop Traumatol Surg Res
Pays: France
ID NLM: 101494830
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
06
01
2019
revised:
29
10
2019
accepted:
13
11
2019
pubmed:
18
2
2020
medline:
25
6
2021
entrez:
17
2
2020
Statut:
ppublish
Résumé
Nerve repair is the gold standard for treatment of radial palsy. In case of failure or contraindication, palliative techniques using tendon transfers provide good results. However, wrist extension frequently shows radial deviation, impairing grip strength. Associating extensor carpi ulnaris (ECU) revival avoids radial deviation. Single-center retrospective study. The inclusion criterion was radial nerve palsy treated by tendon transfers involving revival of the ECU. Nine patients, with a mean age of 33 years [15-60] were included. Four palsies were trauma-induced, 3 tumor-induced and 2 idiopathic. The mean time to treatment was 32 months [4.6-120]. Mean follow-up was 51 months [3-160.7]. Eight patients could be assessed. Wrist extension was balanced in 6 cases, in ulnar deviation in 1 and in radial deviation in the other. Wrist motion was 54° [30°-80°] in extension, 46° [20°-70°] in flexion, with an active motion in the frontal plane of 21° [0°-35°]. Finger extension was possible with the wrist in extension in 6 cases. Thumb abduction was subnormal in 3 cases, incomplete but functional in 4 and barely functional in 1. Fist closure was always complete. Mean QuickDASH score was 41/100 [14-63]. This technique is reliable and reproducible, giving good functional results and avoiding the radial deviation of the wrist in extension observed with traditional techniques. IV.
Sections du résumé
BACKGROUND
BACKGROUND
Nerve repair is the gold standard for treatment of radial palsy. In case of failure or contraindication, palliative techniques using tendon transfers provide good results. However, wrist extension frequently shows radial deviation, impairing grip strength.
HYPOTHESIS
OBJECTIVE
Associating extensor carpi ulnaris (ECU) revival avoids radial deviation.
STUDY DESIGN
METHODS
Single-center retrospective study.
MATERIAL AND METHODS
METHODS
The inclusion criterion was radial nerve palsy treated by tendon transfers involving revival of the ECU. Nine patients, with a mean age of 33 years [15-60] were included. Four palsies were trauma-induced, 3 tumor-induced and 2 idiopathic. The mean time to treatment was 32 months [4.6-120].
RESULTS
RESULTS
Mean follow-up was 51 months [3-160.7]. Eight patients could be assessed. Wrist extension was balanced in 6 cases, in ulnar deviation in 1 and in radial deviation in the other. Wrist motion was 54° [30°-80°] in extension, 46° [20°-70°] in flexion, with an active motion in the frontal plane of 21° [0°-35°]. Finger extension was possible with the wrist in extension in 6 cases. Thumb abduction was subnormal in 3 cases, incomplete but functional in 4 and barely functional in 1. Fist closure was always complete. Mean QuickDASH score was 41/100 [14-63].
CONCLUSION
CONCLUSIONS
This technique is reliable and reproducible, giving good functional results and avoiding the radial deviation of the wrist in extension observed with traditional techniques.
LEVEL OF EVIDENCE
METHODS
IV.
Identifiants
pubmed: 32061574
pii: S1877-0568(20)30042-6
doi: 10.1016/j.otsr.2019.11.026
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
307-310Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.