Published in:
24-07-2023 | Nerve Injury | Original Paper
Functional outcome of synchronous tendon transfer of pronator teres to ECRB with primary nerve repair in high radial nerve injury
Published in: European Journal of Plastic Surgery | Issue 6/2023
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Background
High radial nerve injury results in wrist and finger extension loss. As documented, the greatest loss in function is the weakness of grip due to inability to extend the wrist.
Methods
A Prospective study included 17 patients with acute high radial nerve injury operated on using early pronator teres to Extensor carpi radialis brevis tendon transfer and primary nerve repair from January 2020 to April 2023. Patients were evaluated using active range of motion, grip strength, pinch strength, and DASH score.
Result
Fifteen patients were evaluated at 6 and 9 months post-operative. At 6th-month post-operative, the mean extension range of motion significantly increased, but the mean flexion range of motion slightly decreased. Large grip power was 52.6%, small grip power was 76%, the key pinch was 115%, the palmar pinch was 92%, the tip pinch was 116%, and the mean DASH score was 26.1. At the end of 9 months post-operative follow-up, there was a highly significant increase in extension range of motion and no statistically significant difference between normal and affected limb in flexion range of motion, improvement in large grip power was 58.9%, 80.9% in small grip power, 109% in the key pinch, 103% in the palmar pinch, and 136% in tip pinch and the mean DASH score was 24.8. Three patients had complicated postoperatively by hematoma. Two of them needed no intervention, and one needed ultrasonic-guided aspiration.
Conclusions
It could be concluded that early pronator teres to Extensor carpi radialis brevis tendon transfer with primary repair of the radial nerve in high injuries improves remaining function and quickly restores hand function.
Level of evidence
Level III, Therapeutic.