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Median nerve function after tendon transfer for ulnar paralysis.

J W Brandsma, P W Brand

    Journal of Hand Surgery (Edinburgh, Scotland)
    |February 1, 1985
    PubMed
    Summary
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    Leprosy review·2007

    This study followed 128 leprosy patients with median nerve issues after tendon transfers for claw hand. Using the carpal tunnel for tendon grafts did not significantly impact median nerve palsy development in these high-risk patients.

    Area of Science:

    • Neurology
    • Orthopedic Surgery
    • Infectious Diseases

    Background:

    • Leprosy frequently causes peripheral nerve damage, particularly affecting the median and ulnar nerves.
    • Tendon transfer surgery is a common intervention for correcting claw hand deformities in leprosy patients.
    • Median nerve palsy is a potential complication following surgical interventions for ulnar nerve palsy.

    Purpose of the Study:

    • To evaluate the long-term impact of using the carpal tunnel as a tendon graft pathway on median nerve function in leprosy patients.
    • To determine if the carpal tunnel route influences the incidence or severity of median nerve palsy post-surgery.

    Main Methods:

    • A long-term follow-up study involving 128 leprosy patients who underwent tendon transfers for claw hand.
    • Comparison of median nerve outcomes between patients whose tendon grafts were routed through the carpal tunnel versus those not using this pathway.

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  • Analysis of median nerve palsy incidence and timing in relation to surgical technique and follow-up duration.

    • Main Results:

    • Among 31 cases not using the carpal tunnel, 16% developed median palsy.
    • In 97 cases using the carpal tunnel, 7% had transient and 11% had permanent median palsy.
    • Median nerve palsies occurred months or years post-operatively, not during initial recovery phases.

    Conclusions:

    • Routing tendon grafts through the carpal tunnel did not significantly increase the risk of median nerve palsy in leprosy patients.
    • The carpal tunnel pathway appears safe for median nerves at high risk due to leprosy, despite observed palsy rates.