Choosing Tendon Transfers for Wrist and Digital Extension in Extended Upper Brachial Plexus Injury

Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...

The muscles of the forearm that move the wrist, hand, and digits are numerous and diverse. They can be classified into two groups based on their location and function — the anterior and posterior compartment muscles.
Anterior Compartment
The anterior compartment muscles originate from the humerus. They primarily function as flexors and are also known as flexor muscles. They typically insert on the carpals, metacarpals, and phalanges. The superficial layer includes the flexor carpi...

The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...

The muscles that move the forearms can be divided into four groups: forearm flexors, forearm extensors, forearm pronators, and forearm supinators. The flexors and extensors act on the elbow joint, while the pronators and supinators act on the radioulnar joints.
Forearm Flexors
The biceps brachii, brachialis, and brachioradialis are forearm flexors. The biceps brachii is made up of two heads. Its long head originates at the supraglenoid tubercle of the scapula, whereas that of the short head is...

The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...