Tendon Transfers: Part I. Principles of Transfer and Transfers for Radial Nerve Palsy

Abstract

Objectives After reading this article (part I of II), the participant should be able to: 1. Describe the history of tendon transfer procedures. 2. List and understand the principles and biomechanics of tendon transfers. 2. Describe the anatomy and function of the radial nerve in the forearm and hand. 3. Describe the indications, benefits, and drawbacks for various tendon transfer procedures performed for radial nerve palsy. Summary This article reviews the history of tendon transfer procedures, and describes the principles and biomechanics behind them. It also discusses the anatomy and clinical findings of radial nerve palsy, and the tendon transfer procedures used to treat it.

Nerve Transfer to the Triceps After Brachial Plexus Injury: Report of Four Cases

“…Using a separate incision in the dorsal forearm, median to radial nerve transfer was performed with additional pronator teres tendon transfer to the extensor carpi radialis brevis tendon. [42][43][44] Eight months postoperatively, the patient had recovered M3 elbow extension strength with pinch and grip strength of 5.0 and 29.5 kg (11 and 65 lb) on the right, compared with 10.9 and 38.6 kg (24 and 85 lb) on the left. At 2 years after surgery, elbow extension strength had improved to grade M4ϩ and pinch and grip strength were 13.2 and 44.0 kg (29 and 97 lb) on the right, compared with 13.2 and 45.8 kg (29 and 101 lb) on the left.…”

Radial nerve palsy

“…Tendon transfer surgery must restore finger, thumb and wrist function without inflicting other motor deficits on the hand. 60-62 …”

Tendon transfers

“…6 Burkhalter has also advocated the use of early tendon transfer as an adjunct to nerve repair to retain function and reduce development of contractures during nerve recovery. 6 Burkhalter has also advocated the use of early tendon transfer as an adjunct to nerve repair to retain function and reduce development of contractures during nerve recovery.…”