TREATMENT OF IRRECOVERABLE RADIAL NERVE PALSY USING THE MODIFIED MERLE D'AUBIGNÉ TENDON TRANSFER METHOD

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Reconstructive Surgery

Background:

• Irrecoverable radial nerve palsy (RNP) results in significant functional loss, including inability to extend the wrist and fingers and reduced grip strength.
• Tendon transfer surgery is a potential solution for severe RNP cases where nerve repair is not feasible.

Purpose of the Study:

• To evaluate the outcomes of the modified Merle d'Aubigné tendon transfer for treating non-recovering motor RNP.
• To assess functional recovery, patient satisfaction, and return to work after the procedure.

Main Methods:

• A prospective study of 33 patients with irrecoverable RNP treated between January 2017 and March 2019.
• The modified Merle d'Aubigné technique involved transferring the pronator teres for wrist extension and flexor carpi radialis for finger extension.

Main Results:

• 93.9% of patients achieved full finger extension with the wrist extended and demonstrated significant improvements in wrist range of motion.
• Grip strength recovery averaged 65.4% of the unaffected side, with no induced radial deviation deformities.
• 32/33 patients reported satisfaction, and 31/33 returned to their previous professions, with 93.9% achieving good or very good results.

Conclusions:

• The modified Merle d'Aubigné tendon transfer is a successful and appropriate method for managing irrecoverable RNP.
• This technique effectively restores hand function, limits deformities, and leads to high patient satisfaction and return to work.
• The procedure is supported by international research and recommended for clinical practice.