Innervation of the Median Nerve Motor Branches in the Forearm and Its Clinical Significance

Caetano, Edie Benedito; Toledo, JoÃo Paulo Nunes; Amaral, SÉrgio Aparecido Do; Vieira, Luiz Ângelo; Pigossi, Beatriz D'Andrea; Andrade, Renato Alves de

doi:10.1590/1413-785220202805235028

Cited by 3 publications

(2 citation statements)

References 13 publications

(19 reference statements)

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“…Significant difficulty as observed by García-López was not encountered by us during PT nerve branch transfer to the ECRB nerve branch and excellent wrist extension function was achieved in our patients. On the other hand, sometimes there are 2 different motor branches to PT, sometimes one motor branch comes from the median nerve together with FCR/PL motor branch [ 11 , 12 ]. If there are two nerve branches to PT, we usually choose the longer one to make sure the suture without any tension.…”

Section: Discussionmentioning

confidence: 99%

Pronator teres nerve branch transfer to the extensor carpi radialis brevis nerve branch for wrist extension reconstruction in proximal radial nerve injury following humeral shaft fractures

Tian

Leng

Wang

et al. 2022

BMC Musculoskelet Disord

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Background Tendon and nerve transfers are used for functional reconstruction in cases of proximal radial nerve injury complicated by humeral fractures in patients who do not show functional recovery after primary nerve repair. The effectiveness of pronator teres (PT) nerve branch transfer to the extensor carpi radialis brevis (ERCB) nerve branch for wrist extension reconstruction was investigated and compared to the results of tendon transfer. Methods This study included 10 patients with proximal radial nerve injury, who did not show functional recovery after primary nerve repair at our hospital between April 2016 and May 2019. The nerve transfer procedure included PT nerve branch transfer to the ECRB nerve branch to restore wrist extension and the flexor carpi radialis (FCR) nerve branch to the posterior interosseous nerve (PIN) to restore thumb and finger extension. Tendon transfer procedures included PT transfer to the ECRB for wrist extension, FCR transfer to the extensor digitorum communis (EDC) for finger extension and palmaris longus (PL) transfer to the extensor pollicis longus (EPL) for thumb extension. Results Five patients recovered Medical Research Council grade M4 muscle strength in the ECRB and EPL in both tendon and nerve groups. Two patients recovered grade M3 strength and three patients recovered grade M4 strength in the EDC in the tendon transfer group, and all five patients recovered grade M4 strength in the EDC in the nerve transfer group. Limited wrist flexion was observed only in one patient in the tendon transfer group. Conclusion PT nerve branch transfer to the ECRB nerve branch combined with FCR nerve branch transfer to PIN is a useful strategy for wrist and fingers extension reconstruction in patients with proximal radial nerve injuries.

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Section: Discussionmentioning

confidence: 99%

Pronator teres nerve branch transfer to the extensor carpi radialis brevis nerve branch for wrist extension reconstruction in proximal radial nerve injury following humeral shaft fractures

Tian

Leng

Wang

et al. 2022

BMC Musculoskelet Disord

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“…In more than 35% of cases, the FDS receives two motor branches: one emerging distal to the FCR motor branch and another running further distally (Caetano et al., 2020). As the topographic anatomy of the median nerve to the FDS is relatively constant, intraoperative electrical stimulation combined with careful preoperative clinical examination may afford safe and reliable outcomes for patients with idiopathic primary focal dystonia.…”

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confidence: 99%