There are very few descriptions of tendon transfers designed specifically to address
the reconstruction of posterior interosseous nerve palsy (PINP). Unlike a radial nerve
palsy (RNP), a patient with a PINP is able to extend their wrist but in radial deviation,
because of the preserved innervation of the extensor carpi radialis longus (ECRL).
Tendon transfers to restore finger and thumb extension in PINP have been extrapolated
from tendon transfers to restore these functions in RNP, specifically using flexor
carpi radialis, not flexor carpi ulnaris, so as not to further exacerbate the distinctive
radial deviation deformity of the wrist. However, the standard pronator teres to extensor
carpi radialis brevis transfer for a RNP fails to address or correct the radial deviation
deformity in PINP. We present a simple tendon transfer specifically to address this
radial deviation deformity in a PINP, by performing a side-to-side tenorrhaphy of
the ECRL tendon to the extensor carpi radialis brevis tendon, followed by transection
of the ECRL insertion onto the base of the index finger metacarpal distal to the tenorrhaphy.
This technique converts a functioning ECRL from a radially deforming force, transferring
its vector of pull onto the base of the middle finger metacarpal and so producing
centralization of wrist extension in axial alignment with the forearm.
Key words
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Article info
Publication history
Published online: March 06, 2023
Accepted:
January 15,
2023
Received:
October 9,
2021
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
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Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
