A Comparative Study on Tendon Transfer Surgery for Median and Radial Nerve Injuries

Document Type : Original Article

Authors

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.

Keywords

Main Subjects

References

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The Egyptian Journal of Plastic and Reconstructive Surgery
Volume 42, Issue 1
January 2018
Pages 139-144

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