Distal nerve transfers for radial nerve reinnervation and hand function restoration

Area of Science:

• Neurosurgery
• Orthopedics
• Reconstructive Surgery

Background:

• Radial nerve palsy causes significant functional deficits, including wrist drop and loss of hand extension.
• Direct nerve repair or grafting may be insufficient for extensive radial nerve injuries.

Purpose of the Study:

• To evaluate the efficacy of distal median-to-radial nerve transfers in restoring hand extension.
• To assess the impact of this nerve transfer on patients' quality of life.

Main Methods:

• A prospective study involving nine patients with radial nerve injuries.
• Surgical technique included transferring median nerve branches to the radial nerve and posterior interosseous nerve.
• Pronator teres to extensor carpi radialis brevis tendon transfer was used for chronic cases.
• Functional recovery and quality of life were assessed using standardized scales (BMRC, PNSQoL).

Main Results:

• All patients demonstrated satisfactory recovery of wrist, finger, and thumb extension (BMRC M3-M5).
• Predominant outcomes were M4-M5, particularly for wrist extension.
• Patient-reported quality of life significantly improved, with 88.9% reporting excellent outcomes.

Conclusions:

• Distal median-to-radial nerve transfer is a reliable method for restoring hand extension in proximal radial nerve injuries.
• The procedure leads to significant improvements in patient-reported outcomes and quality of life.
• Larger multicenter studies are recommended to further validate these findings.