Purpose
Radial nerve damage results in substantial functional limitations of the upper extremity.
No detailed data exist regarding long-term results, patient satisfaction, and professional
and social reintegration after tendon transfer for irreparable damage to the radial
nerve. In this retrospective study, we investigated these data through the Disabilities
of the Arm, Shoulder, and Hand (DASH) questionnaire.
Methods
Between 1995 and 2006, 77 patients underwent a modified Brooks and d'Aubigne surgical
technique for radial nerve palsy in our department. In 19 cases, the flexor carpi
radialis muscle was used as a donor instead of the flexor carpi ulnaris muscle. The
mean follow-up period was 60 months (range, 24–150 months); motion of the wrist and
finger joints and pinch-grip power were compared with the healthy side. We assessed
the limitation in pursuing daily activities using the DASH score.
Results
Wrist extension averaged 73% of the contralateral side, whereas the value for movement
of digital extension was 32% and for thumb abduction in the palmar direction it was
80%. The power grip was reduced to 49% and the pinch grip was reduced to 28%. The
mean DASH score was 15 ± 9, the symptom score mean was 15 ± 7, and the working score
mean was 12 ± 10. The mean total DASH score was 16 ± 10. The proportion of patients
who remained employed after surgical treatment was 89%.
Conclusions
Functional results, adequate patient satisfaction, and sufficient professional and
social reintegration can be achieved after modified Brooks and d'Aubigne tendon transfer.
Accordingly, the tendon transfer offers an important alternative—possibly the procedure
of choice—to microsurgical nerve reconstruction, particularly when early professional
and social reintegration is important.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Accepted:
November 14,
2008
Received:
May 4,
2008
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2009 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
