Samy, A., Hafez, A. (2018). A Comparative Study on Tendon Transfer Surgery for Median and Radial Nerve Injuries. The Egyptian Journal of Plastic and Reconstructive Surgery, 42(1), 139-144. doi: 10.21608/ejprs.2018.215079
Ahmed M Samy; Ahmed A Hafez. "A Comparative Study on Tendon Transfer Surgery for Median and Radial Nerve Injuries". The Egyptian Journal of Plastic and Reconstructive Surgery, 42, 1, 2018, 139-144. doi: 10.21608/ejprs.2018.215079
Samy, A., Hafez, A. (2018). 'A Comparative Study on Tendon Transfer Surgery for Median and Radial Nerve Injuries', The Egyptian Journal of Plastic and Reconstructive Surgery, 42(1), pp. 139-144. doi: 10.21608/ejprs.2018.215079
Samy, A., Hafez, A. A Comparative Study on Tendon Transfer Surgery for Median and Radial Nerve Injuries. The Egyptian Journal of Plastic and Reconstructive Surgery, 2018; 42(1): 139-144. doi: 10.21608/ejprs.2018.215079
A Comparative Study on Tendon Transfer Surgery for Median and Radial Nerve Injuries
The Department of General Surgery, Plastic Surgery Unit, Faculty of Medicine, Cairo University
Abstract
Background: Median and radial nerve injuries are very frequent in patients admitted at our trauma department for upper limb injuries. Aim of Work: To perform a study on tendon transfer surgery for median and radial nerve injuries. Methods: Eight cases of median nerve injury (Group A) and eight cases of radial nerve injury (Group B) were included in our study. Group A was further subdivided into group A1 and group < br />A2, each including four cases. In group A1, opponensplasty was performed using extensor indices tendon transfer, via dissecting the tendon till the level of extensor retinaculum at the dorsal wrist level, tendon transfer performed through subcutaneous tunnels, using pisiform bone as hammock and suturing the tendon at the recipient site to the abductor pollicus brevis muscle. In group A2, opponensplasty was performed using extensor indices tendon transfer, via dissecting the tendon till the level of its musculotendinious junction at the distal region of the dorsum of the forearm, tendon transfer performed through deep tunnels, using ulnar styloid process as hammock and suturing the tendon at the recipient site to the abductor pollicus brevis muscle and the capsule of metacarpophalangeal joint of the thumb. Group B was further subdivided into group B1 and group < br />B2, each including four cases. In group B1, triple transfer was performed, using subcutaneous tunnels, with creating an angle of 45 degrees between the donor and recipient tendons at suturing site. Fish mouth weaving technique was used. In group B2, triple transfer was performed, using deep < br />tunnels, with creating an angle of more than 45 degrees between the donor and recipient tendon at suturing site. Fish mouth weaving technique was used. Results: According to our study, it has been found that it may be better during performing opponensplasty to; dissect the extensor indices muscle till the level of its musculoten- 139 dinious at the distal region of the dorsum of the forearm, dissect tunnels at deep plane for tendon transfer, use ulnar styloid process as hammock and include the capsule of the metacarpophalangeal joint of the thumb during suturing technique. It has also been found that it may be better during performing triple tendon transfer for radial nerve injury to; dissect tunnels at superficial plane and create an angle 45 degrees between the donor and recipient tendon at suturing site.
Barton N.J.: Radial nerve lesions. Hand., 5: 200-208, 1973. 2- Epps Ch. H.: Fractures of the shaft of the humerus. In Rockwood C.A. and Green D.P. Fractures in adults, 2nd ed. Philadelphia, Lippincott, 653, 1984. 3- Sunderland S.: Nerves & nerve injuries. Churchill Livingstone, 802, 1978. 4- Pollock F.H., Drake D.G. and Bovil E.G.: Treatment of radial neuropathy associated with fractures of the humerus. J. Bone. Joint. Surg., 63A, 239, 1981. 5- Samardzic M., Grujicic D. and Milinkovic Z.B.: Radial nerve lesions associated with fractures of the humeral shaft. Injury, 21: 220-222, 1990. 6- Morris AH.: Irreducible Monteggia lesion with radial nerve entrapment. A case report, J. Bone. Joint. Surg., 56: 1744-1746, 1974. 7- Terzis J.K. and Papakonstantinov K.C.: The surgical ttt 144 Vol. 42, No. 1 / Tendon Transfer for Median & Radial Nerve Palsies of brachial plexus injuries in adults, Plast. Reconstr. Surg., 106: 1097-1124, 2000. 8- Manske P.R.: Compression of the radial nerve by the triceps muscle. A case report, J. Bone. Joint. Surg., 59: 835-836, 1977. 9- Machinnon S.E. and Dellon A.L.: Surgery of the peripheral nerve, New York Thieme, 1988. 10- Sharrard W.J.: Posterior interosseous neuritis. J. Bone. Joint. Surg., 48: 777-780, 1966. 11- Kobayashi J., Mackinnon SE., Watanabe O., Ball D.J. and Hunter D.A.: The effect of duration of muscle denervation on functional recovery in the rat model. Muscle Nerve, 20: 858-866, 1997. 12- Millesi H.: Progress in peripheral nerve reconstruction. World J. Surg, 14: 733-747, 1990. 13- Kruft S., Von Heimburg D. and Reill P.: Treatment of irreversible lesion of the radial nerve by tendon transfer: Indications and long term results of the Merle d’ Aubigne procedure, Plast. Reconstr. Surg., 100: 610-618, 1997. 14- Kristen M., Davidge M., Andrew Y., Lorna C., Kahn B. and Susan E.: Median to Radial nerve transfers for restoration of wrist, finger & thumb extension. Journal. Hand. Surg., 38: 1812-1827, 2013. 15- Anderson G., Lee V. and Sundararaj G.: Extensor indices proprius opponensplasty, Journal. Hand. Surg., 16B: 334-338, 1991. 16- Anderson G., Lee V. and Sundararaj G.: Oppenensplasty by extensor indices & flexor digitorum superficialis tendon transfer, Journal. Hand. Surg., 17B: 611-614, 1992
View on SCiNiTO
Top