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Tendon transfers after peripheral nerve injuries: my preferred techniques.
1Robert A. Chase Center for Hand and Upper Limb Surgery, Stanford University, Stanford, CA, USA.
The Journal of Hand Surgery, European Volume
|August 1, 2019
Summary
Tendon transfers are the primary reconstructive method for upper limb paralytic injuries. This article details preferred tendon transfers for radial, median, and ulnar nerve palsies, offering surgical insights and rehabilitation guidance.
Area of Science:
- Orthopedics
- Hand Surgery
- Reconstructive Surgery
Background:
- Nerve injuries significantly impair upper limb function.
- Nerve-to-nerve transfers are emerging but tendon transfers remain the mainstay for paralytic injuries.
- Restoring hand function after nerve damage is a critical challenge in reconstructive surgery.
Purpose of the Study:
- To present the author's preferred tendon transfer techniques for common nerve palsies affecting hand function.
- To provide a comprehensive guide for surgeons on selecting and performing effective tendon transfers.
- To share long-term clinical experience and insights into predictable outcomes for upper limb reconstruction.
Main Methods:
- Review of a 50-year career experience with various tendon transfer procedures.
- Selection of preferred tendon transfers for high radial, low median, and low ulnar nerve palsies.
- Detailed description of operative techniques, including illustrations and technical tips.
Main Results:
- Identification of tendon transfers yielding the most predictable and consistent functional outcomes.
- Detailed rationale for the chosen reconstructive procedures.
- Guidance on postoperative rehabilitation to optimize functional recovery.
Conclusions:
- Tendon transfers remain the most reliable reconstructive option for paralytic hand injuries.
- The described preferred techniques offer predictable outcomes for specific nerve palsies.
- Comprehensive surgical and rehabilitation strategies are essential for successful upper limb reconstruction.
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