Loss of flexor pollicis longus and radial profundus function results in a deficit of pinch and reduced grip strength in the hand. This palsy can be isolated or commonly included in a lower brachial plexus injury. The brachialis nerve is an available, synergistic, and powerful donor for transfer in these scenarios, especially in C7,8,T1 injuries […]
Radial nerve palsy is a debilitating nerve injury that results in lost of wrist and finger extension, which classically presents as wrist drop. The two reconstructive options for managing this injury are tendon transfers and nerve transfers, each with their advantages and disadvantages. Nerve transfers are able to provide independent finger extension, however there is […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation is part of the 2014 Comprehensive Review of Neurosurgery video lectures and the second part of the Acute Nerve Injury and Repair lecture. Specifically, this presentation discusses nerve transfers for the hand. […]
Injury to the ulnar nerve results in clawing of the hand due to lost of ulnar intrinsic hand muscles, lost of ulnar-innervated wrist/finger flexion, and numbness/pain within the ulnar nerve territory of the hand. To prevent clawing and reconstruct the ulnar intrinsic hand muscles, the anterior interosseous to ulnar motor nerve transfer is an available […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation is the second part of the topic on Acute Nerve Injury and Repair given for the 2012 Comprehensive Review of Neurosurgery video lectures. Specifically, this presentation discusses reconstructive strategies for general topics […]
The supercharge nerve transfer is a procedure that coapts the distal end of a donor nerve to the side of the recipient nerve. Nerve regeneration is facilitated from donor to recipient through a perineurial window to enhance regeneration from the proximal regenerating nerve. This procedure can be used in cases of 2nd/3rd degree nerve injuries […]
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) […]
The median to radial nerve transfer is an available option for restoring radial nerve hand function following nerve injury. This nerve transfer specifically involves the transferring of two sets of nerves. That is, the flexor carpi radialis (FCR) to posterior interosseous nerve (PIN) and the flexor digitorum superficialis (FDS) to extensor carpi radialis brevis (ECRB) […]
For paralysis of ulnar-innervated flexor digitorum profundus (FDP) to the ring and small finger, tenodesis of the ulnar-innervated FDP tendons will allow the median-innervated FDP to drive the function of the ulnar-innervated FDP function. Specifically, the ulnar-innervated FDP tendons are sutured to the FDP tendon to the long finger, while the FDP tendon to the […]
For isolated anterior interosseous nerve palsies, the nerve to the flexor digitorum superficialis (FDS) is an available donor to innervate the anterior interosseous nerve (AIN) for transfer. The FDS and AIN branch are found branching from the median nerve within the same upper-middle forearm region. The nerve to the FDS branches from the median nerve […]
The donor anterior interosseous nerve (AIN) is transferred to the side of the recipient ulnar motor fascicular group within the distal forearm to preserve ulnar nerve motor intrinsics. Guyon’s canal release is a required part and is completed prior to this procedure. Specific to this case, a revision ulnar nerve transposition was completed proximally. This […]