Surgical Procedures

Median to Radial Nerve Tendon Transfers: PT to ECRB, FCR to EDC, PL to EPL

Tendon transfers are an available option for reconstructing wrist and finger/thumb extension following radial nerve injury when nerve transfers are contra-indicated. The donor median-innervated tendons are used to reconstruct the recipient radial-innervated tendons. This tutorial describes the following tendon transfers: (1) pronator teres (PT) to extensor carpi radialis brevis (ECRB), (2) flexor carpi radialis (FCR) to extensor digitorum communis (EDC), and (3) palmaris longus (PL) to extensor pollicis longus (EPL). In this specific case, the patient had a left humeral fracture and lost complete radial nerve function. He consulted with our institution six months following the injury. While he was within the time limitation of nerve transfers, he elected for tendon transfers for radial nerve palsy.

Standard 111202

Extended 111202

POSITION

Supine.

INCISION

Incisions are made along the (1) anterior aspect of the forearm, (2) EDC tendons at the posterior aspect of the distal forearm, and (3) tendon at the base of the thumb.

REFERENCES

  1. Ray WZ, Mackinnon SE. Clinical outcomes following median to radial nerve transfers. J Hand Surg Am. 2011 Feb;36(2):201-8. PMID: 21168979.
  2. Lowe JB 3rd, Tung TR, Mackinnon SE. New surgical option for radial nerve paralysis. Plast Reconstr Surg. 2002 Sep 1;110(3):836-43. PMID: 12172148.
  3. Riordan DC. Tendon transfers in hand surgery. J Hand Surg Am. 1983 Sep;8(5 Pt 2):748-53. PMID: 6313797.
  4. Beasley RW. Tendon transfers for radial nerve palsy. Orthop Clin North Am. 1970 Nov;1(2):439-45. No abstract available. PMID: 5521865.

Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.

One Comment

  1. Wonderful thank you for sharing…. I really appreciate your effort to share knowledge
    Especially for the Surgeon in third world countries
    Best regards

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