Tendon transfer surgery for radial nerve palsy.

Area of Science:

• Orthopedics
• Neurosurgery
• Hand Surgery

Background:

• Radial nerve palsy significantly impacts hand function, necessitating treatment options beyond primary nerve repair.
• Palliative tendon transfer serves as a crucial intervention when direct nerve repair or grafting is not feasible or has failed.

Purpose of the Study:

• To outline the principles and options for palliative tendon transfers in treating radial nerve palsy.
• To discuss the goals of restoring wrist, finger, and thumb extension and abduction.

Main Methods:

• Review of established surgical techniques for tendon transfers in radial nerve palsy.
• Discussion of donor tendon choices, including pronator teres, flexor carpi ulnaris (FCU), flexor carpi radialis, flexor digitorum superficialis (FDS), and palmaris longus (PL).
• Emphasis on patient-centered decision-making based on clinical examination and individual needs.

Main Results:

• Tendon transfers effectively restore wrist extension using pronator teres.
• Various donor tendons (FCU, flexor carpi radialis, FDS) can be used for finger extension, with the optimal choice debated.
• Thumb extension and abduction can be achieved through transfers to the extensor pollicis longus (EPL) or abductor pollicis longus (APL).

Conclusions:

• Palliative tendon transfers offer a reliable solution for functional restoration in radial nerve palsy.
• Successful outcomes depend on appropriate surgical technique, patient selection, and adherence to postoperative rehabilitation.
• Individualized treatment planning, considering patient expectations, is key to satisfactory results.