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Functional outcome of Tendon Transfer for High Radial Nerve Palsy
Keywords:
FCR set of tendon transfer, functional outcome, high radial nerve palsy.Abstract
Objective: To determine the early functional outcome of flexor tendon transfer for high radial nerve palsy.
Methods: This descriptive study was conducted in Millat Orthopedic and Trauma Surgery Hospital Sargodha from 2002 to 2008. Patient selection criteria was: when there was little or no likelihood of sufficient regeneration of damaged radial nerve and damage of the nerve, the extensor muscles supplied by the nerve, or both was beyond repair. FCR set of transfer was done in all patients. Subjective evaluation of improvement in activities of daily living (ADL) was done by interview and completion of a questionnaire. Also asked whether if they have the chance again they would have had the operation. Objective evaluation was done by measuring related active range of motion (ROM), pinch, grip and extensor and residual flexor power by meters preoperatively, at 3 months and six months of follow up.
RESULTS: A total of 69 patients with mean age 39 years. Males were 86% patients while 14% were female. In 71% patients the dominant limb was involved while in 19% nondominant one. The mean follow up period was 20 months (range 8-36 months). Percent value of active ROM in all transfers (n=69) fell into good or excellent categories in most of the cases. Although transferred limb had less power but there was significant functional improvement in all (100%) patients. All reported improvement in daily activities following the procedure and all answered would have the operation again. All patients had returned to their previous job. There was some resting radial wrist deviation in 3 cases but rarely sufficient to require further surgery. Mild bowstringing of the transferred Palmaris Longus to rerouted Extensor Pollicis Longus was noted but was not severe enough to warrant reoperation.
Conclusion: FCR set of tendon transfer for high radial nerve palsy enable the patient to regain wrist extension, finger extension and power of handgrip resulting in a good functionality of the injured limb and patient satisfaction within a relatively short period.
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