Tendon transfer for tardive ulnar nerve palsy

Irreparable damage to the motor function of the ulnar nerve results primarily in paralysis of the intrinsic muscles and reduces the functional capacity of the hand by about one-half. Tendon transfers are therefore indicated when the following grasp functions are impaired: (1) claw hand with dyskinetic finger movements; (2) impaired thumb adduction with limited key pinch power; (3) instability of the index MP joint; (4) adduction weakness of the little finger. The various procedures and transposition techniques are discussed and the author's preferred methods of tendon transfer are presented.