Tendon transfer for radial nerve palsy

Fifty patients (42 males and 8 females) with radial nerve paralysis were treated by tendon transfer. The age range was 20-50 years, and the follow-up period was 2-12 years. The right hand was affected in 39 cases; the left hand in 11. Forty-three of the 50 cases had high radial nerve palsy and 7 had low radial nerve palsy. Irreparable damage to the radial nerve associated with severe humeral shaft fracture was encountered in 38 cases; a penetrating stab wound was the cause in 7 cases; and 5 cases were found as a result of full recovery from brachial plexus palsy. The pronator teres was transferred to the extensor carpi radialis longus and brevis in 43 patients, the flexor carpi ulnaris to the extensor digitorum communis in 40 patients, and the flexor digitorum superficialis of the fourth finger to the extensor digitorum communis in 10 patients. The palmaris longus was transferred to the extensor pollicis longus in all 50 cases. The results of the surgery were excellent in 12 cases, good in 31, and fair in 7. Five cases had mild radial deviation of the hand without disturbance of hand function.