Early tendon transfer for radial nerve transection
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Abstract:
A retrospective comparison of twelve patients with radial nerve transection treated by nerce repair, and thirteen similar patients treated by tendon transfer only, showed an average time to recovery of 7.5 months after nerve repair, and eight weeks after transfer. In view of this, a policy of early tendon transfer instead of radial nerve suture is advised. Results are reported in nine patients who had tendon transfers at an average of thirteen days after nerve injury.Keywords:
Radial nerve
Nerve repair
Tendon transfer
A retrospective comparison of twelve patients with radial nerve transection treated by nerce repair, and thirteen similar patients treated by tendon transfer only, showed an average time to recovery of 7.5 months after nerve repair, and eight weeks after transfer. In view of this, a policy of early tendon transfer instead of radial nerve suture is advised. Results are reported in nine patients who had tendon transfers at an average of thirteen days after nerve injury.
Radial nerve
Nerve repair
Tendon transfer
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Palliative tendon transfer procedures for radial nerve palsy are continuing to evolve. This paper reports outcomes of 10 patients with isolated and traumatic radial nerve palsy underwent minimal transfer. All patients improved functionally and could attend their routine activities. The flexor carpi ulnaris and palmaris longus tendon transfer has some advantages in terms of simplicity, shorter operative time, less morbidity, better wrist and finger extension and thumb extension and abduction.
Tendon transfer
Radial nerve
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The radial nerve is one of the three important nerves of the upper limb which causes the wrist, fingers and thumb extension. Loss of radial nerve function in the hand creates a significant disability with difficulty in grasp and power grip. Injuries to the radial nerve can occur at any point along its anatomical route and the etiology could be either post-traumatic or post-surgical. After irreparable radial nerve injury, the only treatment available is tendon transfer other than arthrodesis. Tendon transfer is a treatment option to compensate for the loss of function of the wrist, fingers and thumb extensions of which the flexor carpi radialis (FCR) and flexor carpi ulnaris (FCU) are the most common used donor tendons. FCR tendon transfer provides better functional results than FCU tendon transfer. There is no standard procedure but the surgeon must tailor the tendon transfer procedure according to the patients needs.
Tendon transfer
Radial nerve
Posterior interosseous nerve
Flexor Carpi Ulnaris
Extensor Carpi Ulnaris
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Twenty-six patients with injury of the tendon of the extensor pollicis longus have been studied and the long term results of the transfer of the tendon of the extensor indicis are reported. Using Geldmacher's evaluation scheme for assessment of the results of extensor tendon reconstruction we found thirteen excellent, ten good, and three fair results. The prognosis is dependent upon the kind of injury and the time after injury of the transfer of the tendon of the extensor indicis.
Tendon transfer
Extensor muscle
Transposition (logic)
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A patient in whom a previously repaired flexor digitorum superficialis tendon was used for transfer to correct a claw deformity is described. I have found this to be possible under optimal conditions of tendon repair, thus providing the hand surgeon with another choice of donor material.
Tendon transfer
Claw
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The in vivo response of foetal flexor digitorum profundus tendons to tendon sutures was studied macroscopically and microscopically in foetal lambs. No tendon adhesions were noted at any of the examination intervals. 4 days after injury, a mild inflammatory reaction was noted around the suture. The tendon examined at the 4-week interval showed evidence of migration of epitenon cells from the outer surface of the tendon into the suture track. The tendon examined at the 6-week interval showed normal tendon fibres surrounding the suture site. Differences between foetal skin and foetal tendon healing are discussed along with the possible role of amniotic fluid in modulating the healing process in the foetus.
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Objective To introduce a new method of tendon transfer for treating radial nerve palsy and evaluate the clinical outcomes. Methods Twelve cases of irreversible radial nerve injuries were treated with the modified Tsuge technique to reconstruct the function of wrist, thumb and finger extension since June 2002.Results All 12 cases were follow-up for 2 to 48 months. According to Chen Desong's 1994 criteria for outcome evaluation of tendon transfers in radial nerve palsy, good results were seen in 10 cases and fair results in 2 cases.The overall satisfactory rate was 100%. One of the 2 cases that showed fair results had brachial plexus cut injury and repair 8 years earlier, which yielded weaker donor for tendon transfer. The other case was accompanied by soft tissue defect of the dorsal forearm that required flap coverage and hence postoperative scarring. Conclusion Modified Tsuge tendon transfer is the most suitable, simple and effective method for functional reconstruction in radial nerve palsy.
Key words:
Radial nerve; Hand injuries; Functional reconstruction; Tendon transfer
Radial nerve
Tendon transfer
Brachial plexus injury
Posterior interosseous nerve
Axillary nerve
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Background: Two main factors determine the strength of tendon repair; the tensile strength of material and the gripping capacity of a suture configuration. Different repair techniques and suture materials were developed to increase the strength of repairs but none of techniques and suture materials seem to provide enough tensile strength with safety margins for early active mobilization. In order to overcome this problem tendon suturing implants are being developed. We designed two different suturing implants. The aim of this study was to measure tendon-holding capacities of these implants biomechanically and to compare them with frequently used suture techniques Materials and Methods: In this study we used 64 sheep flexor digitorum profundus tendons. Four study groups were formed and each group had 16 tendons. We applied model 1 and model 2 implant to the first 2 groups and Bunnell and locking-loop techniques to the 3rd and 4th groups respectively by using 5 Ticron sutures. Results: In 13 tendons in group 1 and 15 tendons in group 2 and in all tendons in group 3 and 4, implants and sutures pulled out of the tendon in longitudinal axis at the point of maximum load. The mean tensile strengths were the largest in group 1 and smallest in group 3. Conclusion: In conclusion, the new stainless steel tendon suturing implants applied from outside the tendons using steel wires enable a biomechanically stronger repair with less tendon trauma when compared to previously developed tendon repair implants and the traditional suturing techniques.
Biomechanics
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Tendon transfer
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