Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation discusses carpal tunnel syndrome (CTS) and median neuropathy in the context of compression neuropathies. In particular, this presentation details the specific nuances for (1) an open carpal tunnel release, (2) revision carpal […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation details reconstructive options for median nerve injuries, specifically nerve transfers to reinnervate the pronator teres and anterior interosseous nerve. These two recipient nerves are critical for median nerve function and strategies for […]
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 a description on the median to radial nerve transfers for management of radial nerve palsies. It was presented at the 2014 ASSH Post-Course on distal nerve transfers for brachial plexus injuries. […]
Sensory nerve transfers are an available option for restoring sensation to critical deinnervated territories. Multiple strategies exist for restoring sensation, which include end-to-end nerve transfers for critical territories and end-to-side nerve transfers for non-critical territories. For sensory deficits in the ulnar nerve, the 3rd webspace fascicle from the median nerve can be utilized as a […]
Compression neuropathy of the median nerve in the forearm, also known as pronator syndrome, typically presents with pain in the forearm +/- paresthesia/pain in the median nerve territory. The anterior interosseous nerve can be involved with a mononeuritis. While this usually resolves without surgery, occasionally will require this approach for reconstruction or release. Related anatomical […]
Carpal tunnel syndrome is a compression neuropathy of the median nerve as it travels through the carpal tunnel deep to the transverse carpal ligament. This causes paresthesia and pain in the territory of the median nerve and weakness of the thenar muscles depending on the severity of the neuropathy. Paresthesia is most typically in the […]
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 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 double fascicular transfer (DFT) includes two nerve transfers: (1) median fascicle to biceps branch and (2) ulnar fascicle to brachialis branch. The median fascicle contains nerve fibers that innervate flexor digitorum superficialis / flexor carpi radialis. The ulnar fascicle contains nerve fibers that innervate flexor carpi ulnaris. The donor fascicles can be used for […]
A carpal tunnel release is performed by decompressing the median nerve in the wrist through the carpal tunnel. This procedure involves transecting the transverse carpal ligament. Standard: POSITION Supine. INCISION An incision is made ulnar to the thenar crease between the palmar sensory territories of the median and ulnar nerve. In addition, this approach allows […]
The median nerve is decompressed in the forearm. A Z-plasty lengthening is performed on the pronator teres tendon. In addition, the tendon of the deep head of the pronator teres is transected and the flexor digitorum superficialis tendinous arch is released. Standard: Extended: POSITION Supine. INCISION A lazy-S incision is made over the proximal forearm. […]