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Updated: May 28, 2026
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Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
Tendon transfer for median nerve palsy.
1Apollo Hospitals, Chennai, Tamilnadu, India.
Summary
This article details a surgical approach for forearm injuries since 1995, primarily using the flexor digitorum superficialis (FDS) and extensor pollicis indicis (EPI) muscles. The method involves selecting appropriate motors, pulleys, and inserts for optimal patient outcomes.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Hand Surgery
Background:
- The article reviews a surgical technique for forearm injuries implemented since 1995.
- The primary patient group involved those with lower forearm injuries, including Hansen's disease patients.
Purpose of the Study:
- To describe a refined surgical approach for forearm reconstruction.
- To outline the selection criteria for motors, pulleys, and inserts in tendon transfers.
Main Methods:
- The approach categorizes the procedure into three main components: motor selection, pulley creation, and insert placement.
- Commonly utilized motors included the flexor digitorum superficialis (FDS) and extensor pollicis indicis (EPI).
- The Guyon's canal and distal ulna served as frequent pulley sites, with abductor pollicis brevis (APB) and extensor pollicis longus (EPL) slips used for insertion.
Main Results:
- The use of ECU transfer was limited due to potential radial deviation of the wrist.
- PL transfer with palmar aponeurosis extension was also used sparingly.
- APB and EPL two-slip insertions demonstrated favorable outcomes.
Conclusions:
- The described surgical approach offers a systematic method for forearm reconstruction.
- Flexibility in combining different motors, pulleys, and inserts allows for tailored treatment based on individual patient needs.
- The FDS and EPI remain the primary choices for tendon transfers in this technique.
