Flexor Digitorum Superficialis Tendon Transfer for Wrist Extension

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Hand Surgery

Background:

• Peripheral nerve injuries, particularly those affecting the radial nerve, can lead to significant loss of wrist extension.
• This functional deficit impairs grip strength, pinch, and overall hand coordination.
• Tendon transfers are a primary surgical approach to restore wrist extension.

Purpose of the Study:

• To describe a novel technique for restoring wrist extension using two flexor digitorum superficialis (FDS) tendons.
• To provide an effective surgical option for patients with radial nerve lesions causing wrist drop.
• To detail the operative procedure, including tendon routing and fixation.

Main Methods:

• A novel tendon transfer technique involving the long and ring finger FDS tendons is described.
• One FDS tendon is routed through the interosseous membrane, while the second is routed radially around the wrist.
• Tendons are attached to the third metacarpal bone to restore wrist extension and control forearm rotation.

Main Results:

• The described technique offers a method to restore wrist extension in cases of radial nerve palsy.
• Routing of FDS tendons can be adjusted to influence forearm pronation or supination.
• Early functional recovery is expected within 3 months, with full recovery anticipated at 6 months.

Conclusions:

• This novel FDS tendon transfer technique provides a valuable option for reconstructing wrist extension in radial nerve injuries.
• The technique allows for tailored control of forearm rotation alongside wrist extension.
• The synergistic nature of FDS with wrist extension facilitates straightforward patient rehabilitation.