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Functional and Physiological Methods of Evaluating Median Nerve Regeneration in the Rat
Published on: April 18, 2020
Motor nerve transfers to restore extrinsic median nerve function: case report
Eugene C Hsiao1, Ida K Fox, Thomas H Tung
1Department of Surgery, Division of Plastic and Reconstructive Surgery, School of Medicine, Washington University, 660 S Euclid, Campus Box 8238, Saint Louis, MO 63110, USA.
Hand (New York, N.Y.)
|September 23, 2008
Summary
Restoring pronation after humerus fracture involves nerve transfers. A novel technique using radial nerve branches successfully restored median nerve function, improving hand and wrist movement.
Area of Science:
- Orthopedic Surgery
- Neuroscience
- Reconstructive Surgery
Background:
- Active pronation is crucial for daily activities.
- Loss of median nerve function, including pronation, is a rare complication of humerus fractures.
- Traditional tendon transfers for pronation are typically reserved for other conditions.
Purpose of the Study:
- To describe a novel nerve transfer technique for restoring active pronation and median nerve function after a humerus fracture.
- To evaluate the clinical outcomes of this nerve transfer procedure.
Main Methods:
- A case report detailing a nerve transfer procedure.
- Transfer of the extensor carpi radialis brevis branch of the radial nerve to the pronator teres branch of the median nerve.
- Transfer of the supinator branch of the radial nerve to the anterior interosseous nerve.
Main Results:
- Clinically evident motor function recovery was observed starting at 4 months postoperatively.
- Significant improvement in pronation, flexor pollicis longus, and index finger flexor digitorum profundus strength was noted over 18 months.
- The patient achieved 4+/5 strength in pronator teres and flexor pollicis longus, and 4-/5 in index finger flexor digitorum profundus.
Conclusions:
- Nerve transfers offer an effective treatment for restoring active pronation lost due to humerus fractures.
- This previously unreported nerve transfer technique successfully restored extrinsic median nerve function with minimal donor deficit and no prolonged immobilization.
- The procedure reinnervates muscles in their native locations, preserving motor end plates for optimal recovery.
